Healthcare Provider Details

I. General information

NPI: 1457217689
Provider Name (Legal Business Name): REINVENTION PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6909 W RAY RD STE 21
CHANDLER AZ
85226-1525
US

IV. Provider business mailing address

6909 W RAY RD STE 21
CHANDLER AZ
85226-1525
US

V. Phone/Fax

Practice location:
  • Phone: 480-851-4041
  • Fax:
Mailing address:
  • Phone: 480-851-4041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHELLEY LEE CORRIGAN
Title or Position: OWNER
Credential: LCSW
Phone: 480-851-4041