Healthcare Provider Details

I. General information

NPI: 1134873805
Provider Name (Legal Business Name): FIREFLY THERAPY CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 BRENDAN WAY
GREENVILLE SC
29615-3514
US

IV. Provider business mailing address

35 BRENDAN WAY
GREENVILLE SC
29615-3514
US

V. Phone/Fax

Practice location:
  • Phone: 864-775-6685
  • Fax: 864-551-4440
Mailing address:
  • Phone: 864-775-6685
  • Fax: 864-551-4440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: PATRICK BROWN
Title or Position: OWNER
Credential:
Phone: 864-775-6685