=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003724360
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RLUNDERHILL PSYCHOTHERAPY AND HEALING LLC (DBA DRAGON FIRE HEALING COLLECTIVE)
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2026
-----------------------------------------------------
Last Update Date | 08/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3728 13TH AVE S
-----------------------------------------------------
City | MINNEAPOLIS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55407-2710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-404-0136
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3728 13TH AVE S
-----------------------------------------------------
City | MINNEAPOLIS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55407-2710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-404-0136
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MENTAL HEALTH THERAPIST
-----------------------------------------------------
Name | RYANNE UNDERHILL
-----------------------------------------------------
Credential | MSW, LICSW
-----------------------------------------------------
Telephone | 612-404-0136
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------