Holistic Bonfire LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37PC00425500 Issued in NJ

Legal business name

HOLISTIC BONFIRE LLC

Practice address

258 Newark St
Suite 205
Hoboken, NJ 07030-3419

Phone

(908) 376-9036

NPI assigned

Feb 7, 2017

Organization subpart

No

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

Authorized official

Name

Suruchi Saini, MA, LPC, NCC, CCTP

Title

Principal

Phone

(908) 376-9036

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705276800000",
    "number": "1962940270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 BUCKINGHAM DR",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088546259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 NEWARK ST",
            "address_2": "SUITE 205",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303419",
            "telephone_number": "908-376-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC BONFIRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-07",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A",
        "authorized_official_last_name": "SAINI",
        "authorized_official_first_name": "SURUCHI",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "908-376-9036",
        "authorized_official_credential": "MA, LPC, NCC, CCTP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00425500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.