Provider Demographics
NPI:1134873805
Name:FIREFLY THERAPY CLINIC LLC
Entity type:Organization
Organization Name:FIREFLY THERAPY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-775-6685
Mailing Address - Street 1:35 BRENDAN WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3514
Mailing Address - Country:US
Mailing Address - Phone:864-775-6685
Mailing Address - Fax:864-551-4440
Practice Address - Street 1:35 BRENDAN WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3514
Practice Address - Country:US
Practice Address - Phone:864-775-6685
Practice Address - Fax:864-551-4440
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIREFLY THERAPY CLINIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty