Provider Demographics
NPI:1326482563
Name:FIREFLY INSTITUTE
Entity Type:Organization
Organization Name:FIREFLY INSTITUTE
Other - Org Name:FIREFLY COUNSELING SERVICES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PLISKE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LCSW RPT
Authorized Official - Phone:503-560-5822
Mailing Address - Street 1:4950 NE BELKNAP CT STE 205
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5115
Mailing Address - Country:US
Mailing Address - Phone:503-560-5822
Mailing Address - Fax:888-503-2864
Practice Address - Street 1:4950 NE BELKNAP CT
Practice Address - Street 2:SUITE 205
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5113
Practice Address - Country:US
Practice Address - Phone:503-560-5822
Practice Address - Fax:888-503-2864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL5487251S00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500676403Medicaid