Bold Buddies LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BOLD BUDDIES LLC

Practice address

1320 Central Park Blvd
Fredericksburg, VA 22401-4942

Phone

(732) 338-9887

NPI assigned

Jun 20, 2024

Last updated

Jul 1, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ephraim Gross

Title

Business Manager

Phone

(732) 338-9887

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1205670601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ASHFORD RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085271701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 CENTRAL PARK BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014942",
            "telephone_number": "732-338-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLD BUDDIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "EPHRAIM",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "732-338-9887"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Anne Bodin, FNP
• Sean R Bodin, PA
• Tira Janette Boenecke, MOTR/L
• Donald Lewis Bohannon, LPC
• Bold Beginnings, LLC
• Lisa Goodwin Bollow, MA
• Kristina Bonanca, LPC
• Megan Anne Bone, LAT, ATC
• Bones Inc Dba Schulz Chiropractic Center
• John Boniface Jr., M.D.

• Behavior Analyst in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.