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General NPI Number Information
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NPI Number | 1528824398
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Entity Type | Organization
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Legal Business Name | DRAGONFLY BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 101 N 11TH ST APT 242
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City | FORT SMITH
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State | AR
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Zip | 72901-2451
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Country | US
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Telephone | 479-420-5159
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Fax |
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Provider Business Mailing Address
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Address Line | 2219 S 67TH ST
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City | FORT SMITH
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State | AR
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Zip | 72903-4014
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Country | US
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Telephone | 479-420-5159
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | SHERYL L HOLLINGSHEAD
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Credential | LPC
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Telephone | 479-420-5159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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