Provider Demographics
NPI:1164931812
Name:RETRIBE TRANSFORMATIONS, L3C LLC
Entity Type:Organization
Organization Name:RETRIBE TRANSFORMATIONS, L3C LLC
Other - Org Name:RETRIBE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCMHC
Authorized Official - Phone:609-598-2182
Mailing Address - Street 1:663 GUYETTE RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05667-9054
Mailing Address - Country:US
Mailing Address - Phone:609-933-0877
Mailing Address - Fax:609-818-9206
Practice Address - Street 1:663 GUYETTE RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:VT
Practice Address - Zip Code:05667-9054
Practice Address - Country:US
Practice Address - Phone:609-933-0877
Practice Address - Fax:609-818-9206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00454700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty