Healthcare Provider Details

I. General information

NPI: 1497478838
Provider Name (Legal Business Name): DANDELION SPIRIT PSYCHOTHERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 10/05/2025
Certification Date: 10/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9220 BASS LAKE RD STE 305
NEW HOPE MN
55428-3115
US

IV. Provider business mailing address

9220 BASS LAKE RD STE 305
NEW HOPE MN
55428-3115
US

V. Phone/Fax

Practice location:
  • Phone: 651-212-5127
  • Fax:
Mailing address:
  • Phone: 651-212-5127
  • Fax: 855-828-9067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KAI Y GUNTY
Title or Position: OWNER
Credential: PHD, LMFT, LPCC
Phone: 651-212-5127