CANYON REPOSE LLC
NPI 1376420596
Counselor - Mental Health in Phoenix, AZ

Q: What is Canyon Repose LLC's NPI number?

The NPI number for Canyon Repose LLC is 1376420596. It was assigned to this organization in the NPPES registry on August 19, 2025.

Q: What is Canyon Repose LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Canyon Repose LLC was last updated on September 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 19, 2025

8102 N 23RD AVE STE B, PHOENIX, AZ 85021(602) 326-1828 Get Directions Write a Review

NPPES record last updated: September 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Canyon Repose Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CANYON REPOSE LLC (NPI 1376420596) is a healthcare organization registered as a mental health in Phoenix, Arizona and active in the NPI registry since August 2025. The organization lists Jerry Maroney, Director, as its authorized official.

NPPES Registry Identity

NPI1376420596

Entity TypeOrganization

Primary Taxonomy101YM0800X

Legal Business NameCANYON REPOSE LLC

Location Address8102 N 23RD AVE STE BPhoenix, AZ 85021-4962

Mailing Address205 E Osborn Rd # 101Phoenix, AZ 85012-2327 · (602) 628-0601

Phone(602) 326-1828

Organization SubpartNo

Authorized OfficialJerry MaroneyDirector · (602) 326-1828

Enumeration DateAugust 19, 2025

Last NPPES UpdateSeptember 12, 2025

NPPES CertifiedSeptember 12, 2025

✔ NPI 1376420596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedInternal Medicine · Addiction MedicineTaxonomy 207RA0401X

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X

8102 N 23RD AVE STE B, Phoenix, AZ 85021

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Canyon Repose LLC's NPI number?

The NPI number for Canyon Repose LLC is 1376420596. It was assigned to this organization in the NPPES registry on August 19, 2025.

Where is Canyon Repose LLC located?

Canyon Repose LLC is located at 8102 N 23rd Ave Ste B, Phoenix, AZ 85021. The listed phone number is (602) 326-1828.

What is Canyon Repose LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Canyon Repose LLC was last updated on September 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.