Inner Light Therapeutics, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

INNER LIGHT THERAPEUTICS, LLC

Practice address

637 Wyckoff Ave Ste 172
Wyckoff, NJ 07481-1438

Phone

(201) 298-1402

NPI assigned

Jul 23, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Bonnie Lyn Freirich, LCSWNPI 1447659354

Title

Owner/Clinical Social Worker

Phone

(201) 298-1402

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bonnie Lyn Freirich, L.C.S.W.

  • Clinical Social Worker
  • Maywood, NJ
  • NPI 1447659354
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595462400000",
    "number": "1174132492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WYCKOFF AVE STE 172",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811438",
            "telephone_number": "201-298-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 WYCKOFF AVE STE 172",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811438",
            "telephone_number": "201-298-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER LIGHT THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "FREIRICH",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "OWNER/CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "201-298-1402",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Wyckoff, NJ
• Providers in Wyckoff, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.