MEDICARE: FIREFLY COUNSELING COMMONS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1457114167
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIREFLY COUNSELING COMMONS

Provider Business Mailing Address
First Line	:	55 S STATE AVE STE 3113
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-3802
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 S STATE AVE STE 3113
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-3802
Country	:	US
Telephone Number	:	317-513-4408
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MADELINE STEALY
Credential	:
Telephone Number	:	631-478-8887

Provider Enumeration Date	:	02/05/2024
Last Update Date	:	02/05/2024

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Directions to “FIREFLY COUNSELING COMMONS ” Practice Location

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