Healthcare Provider Details

I. General information

NPI: 1154272045
Provider Name (Legal Business Name): DRAGONFLY THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 N DEARING RD
PARMA MI
49269-9779
US

IV. Provider business mailing address

5401 N DEARING RD
PARMA MI
49269-9779
US

V. Phone/Fax

Practice location:
  • Phone: 517-206-6065
  • Fax:
Mailing address:
  • Phone: 517-206-6065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERIN EGAN
Title or Position: OWNER
Credential: LMSW
Phone: 517-206-6065