Organization Active NPI

Unchained-Gilbert LLC

Doing business as Unchained Wellness Clinic

  • Psychiatry Physician
  • Gilbert, AZ
National Provider Identifier
1578274346
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
UNCHAINED-GILBERT LLC
Doing business as
Unchained Wellness Clinic
Practice address
201 W Guadalupe Rd Ste 302
Gilbert, AZ 85233-3333
Phone
(480) 536-9473
Fax
(480) 536-9744
NPI assigned
Dec 12, 2022
Last updated
Apr 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mason Lundell
Title
Owner
Phone
(480) 536-9473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

201 W Guadalupe Rd Ste 302
Gilbert, AZ 85233-3333

Mailing address

201 W Guadalupe Rd Ste 302
Gilbert, AZ 85233-3333
Phone (480) 536-9473

Other names 1

  • Unchained Wellness Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230524002283 AZ Part B Supplier - Clinic/Group Practice 8527424100 Receives reassigned benefits from 2 practitioners
Practice locations: Gilbert, AZ

National Provider Directory

National Provider Directory

Locations

201 W Guadalupe Rd
Ste 302
Gilbert, AZ 85233
Phone (480) 536-9473

201 W Guadalupe Rd
Ste 310
Gilbert, AZ 85233
Phone (480) 813-0944

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744070400000",
    "number": "1578274346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W GUADALUPE RD STE 302",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852333333",
            "telephone_number": "480-536-9473",
            "fax_number": "480-536-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W GUADALUPE RD STE 302",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852333333",
            "telephone_number": "480-536-9473",
            "fax_number": "480-536-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNCHAINED-GILBERT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-12",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "LUNDELL",
        "authorized_official_first_name": "MASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-536-9473"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Unchained Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Unchained Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.