Healthcare Provider Details

I. General information

NPI: 1851213656
Provider Name (Legal Business Name): BLOOM AND PROSPER THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1948 N HAMILTON PL
CHANDLER AZ
85225-8425
US

IV. Provider business mailing address

1948 N HAMILTON PL
CHANDLER AZ
85225-8425
US

V. Phone/Fax

Practice location:
  • Phone: 602-301-4771
  • Fax: 480-452-0891
Mailing address:
  • Phone: 602-301-4771
  • Fax: 480-452-0891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: RENEE KATHLEEN WILLIAMS
Title or Position: THERAPIST/ OWNER
Credential: LCSW
Phone: 602-301-4771