Healthcare Provider Details

I. General information

NPI: 1114883337
Provider Name (Legal Business Name): DRAGONFLY LANDING FAMILY SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 LA MONTANA WAY STE 200
COLORADO SPRINGS CO
80918-6735
US

IV. Provider business mailing address

2270 LA MONTANA WAY STE 200
COLORADO SPRINGS CO
80918-6735
US

V. Phone/Fax

Practice location:
  • Phone: 719-660-5798
  • Fax: 303-344-9812
Mailing address:
  • Phone: 719-660-5798
  • Fax: 303-344-9812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: KEBRINA CHIRDON
Title or Position: CEO
Credential:
Phone: 719-660-5798