Provider Demographics
NPI:1528721628
Name:DRAGONFLY BEHAVIORAL SERVICES, LLC
Entity type:Organization
Organization Name:DRAGONFLY BEHAVIORAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:CIRINO
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:440-423-5870
Mailing Address - Street 1:8430 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2580
Mailing Address - Country:US
Mailing Address - Phone:440-423-5870
Mailing Address - Fax:
Practice Address - Street 1:8430 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-2580
Practice Address - Country:US
Practice Address - Phone:440-423-5870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-16
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health