Organization Active NPI

Dragonfly Haven of the Adirondacks LCSW, PLLC

  • Adolescent and Children Mental Health Clinic/Center
  • Glens Falls, NY
National Provider Identifier
1689303869
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
DRAGONFLY HAVEN OF THE ADIRONDACKS LCSW, PLLC
Practice address
333 Glen St Ste 603
Glens Falls, NY 12801-3666
Phone
(838) 234-0288
Fax
(838) 234-0520
NPI assigned
Jun 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tia Ruggiero, LCSWNPI 1598149395
Title
Owner
Phone
(838) 234-0288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

333 Glen St Ste 603
Glens Falls, NY 12801-3666

Mailing address

333 Glen St Ste 603
Glens Falls, NY 12801-3666
Phone (838) 234-0288

Other identifiers 1

IdentifierTypeStateIssuer
1598149395OtherNYNPPES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220726000427 NY Part B Supplier - Clinic/Group Practice 9234510090 Receives reassigned benefits from 1 practitioner
Practice locations: Glens Falls, NY

National Provider Directory

National Provider Directory

Locations

92 Broad St
Ste 2
Glens Falls, NY 12801
Phone (518) 480-4002

333 Glen St
Ste 603
Glens Falls, NY 12801

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1689303869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 GLEN ST STE 603",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013666",
            "telephone_number": "838-234-0288",
            "fax_number": "838-234-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 GLEN ST STE 603",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013666",
            "telephone_number": "838-234-0288",
            "fax_number": "838-234-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAGONFLY HAVEN OF THE ADIRONDACKS LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-06",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A",
        "authorized_official_last_name": "RUGGIERO",
        "authorized_official_first_name": "TIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "838-234-0288",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1598149395",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.