Healthcare Provider Details

I. General information

NPI: 1376442129
Provider Name (Legal Business Name): DRAGONFLY COUNSELING AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2026
Last Update Date: 11/05/2026
Certification Date: 11/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17232 DEWES RD
BRAINERD MN
56401-5239
US

IV. Provider business mailing address

PO BOX 63
BRAINERD MN
56401-0339
US

V. Phone/Fax

Practice location:
  • Phone: 608-751-1499
  • Fax:
Mailing address:
  • Phone: 608-751-1499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. KIMBERLY ANN OLSON
Title or Position: LICENSED PSYCHOTHERAPIST
Credential: LPCC
Phone: 608-751-1499