Healthcare Provider Details

I. General information

NPI: 1447659727
Provider Name (Legal Business Name): FIREFLY COUNSELING SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2014
Last Update Date: 08/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 SE WASHINGTON ST
HILLSBORO OR
97123-4142
US

IV. Provider business mailing address

535 SE WASHINGTON ST
HILLSBORO OR
97123-4142
US

V. Phone/Fax

Practice location:
  • Phone: 503-560-5822
  • Fax: 888-503-2864
Mailing address:
  • Phone: 503-560-5822
  • Fax: 888-503-2864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberL5487
License Number StateOR

VIII. Authorized Official

Name: MICHELLE MARIE PLISKE
Title or Position: CEO
Credential: MSW LCSW
Phone: 503-560-5822