Healthcare Provider Details

I. General information

NPI: 1487370003
Provider Name (Legal Business Name): DRAGONFLY COUNSELING AND CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2022
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6275 E VIRGINIA BEACH BLVD STE 202
NORFOLK VA
23502-2851
US

IV. Provider business mailing address

1245G CEDAR RD # 210
CHESAPEAKE VA
23322-7103
US

V. Phone/Fax

Practice location:
  • Phone: 757-237-4011
  • Fax:
Mailing address:
  • Phone: 757-237-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIA CHRISTINA KERR
Title or Position: PART OWNER
Credential: LPC, LSATP
Phone: 757-237-4011