MEDICARE: DRAGONFLY RESTORATIVE COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1649120270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRAGONFLY RESTORATIVE COUNSELING, LLC

Provider Business Mailing Address
First Line	:	100 E NEW YORK AVE
Second Line	:	STE 103-BK
City	:	DELAND
State	:	FL
Zip	:	32724-5576
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 E NEW YORK AVE
Second Line	:	STE 103-BK
City	:	DELAND
State	:	FL
Zip	:	32724-5576
Country	:	US
Telephone Number	:	386-342-2172
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BERNADETTE KUCHINSKY
Credential	:	LCSW
Telephone Number	:	386-342-2172

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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