Healthcare Provider Details

I. General information

NPI: 1770419079
Provider Name (Legal Business Name): UNBOUND PSYCHIATRY PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 4TH AVE N
SARTELL MN
56377-1463
US

IV. Provider business mailing address

1301 4TH AVE N
SARTELL MN
56377-1463
US

V. Phone/Fax

Practice location:
  • Phone: 320-291-7821
  • Fax:
Mailing address:
  • Phone: 320-291-7821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: NICOLE DANIEL
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 320-291-7821