MEDICARE: DRAGONFLY THERAPY, L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1154272045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRAGONFLY THERAPY, L.L.C.

Provider Business Mailing Address
First Line	:	5401 N DEARING RD
Second Line	:
City	:	PARMA
State	:	MI
Zip	:	49269-9779
Country	:	US
Telephone Number	:	517-206-6065
Fax Number	:

Provider Business Practice Location Address
First Line	:	5401 N DEARING RD
Second Line	:
City	:	PARMA
State	:	MI
Zip	:	49269-9779
Country	:	US
Telephone Number	:	517-206-6065
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIN EGAN
Credential	:	LMSW
Telephone Number	:	517-206-6065

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “DRAGONFLY THERAPY, L.L.C. ” Practice Location

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