Robert Wallen, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

282633 Issued in AZ

Practice address

14122 W McDowell Rd Ste 203
Goodyear, AZ 85395-2505

Phone

(623) 349-1711

Fax

(623) 399-1958

NPI assigned

Oct 31, 2022

Last updated

Jan 21, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bella Vida TMS LLCGroup PAC ID 7810340874, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: 2ndchancetreatmentcenters.robertwallen@154160.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bella Vida TMS LLC

  • Psychiatry Physician
  • Phoenix, AZ
  • NPI 1215700943
  Medicare reassignment Care Compare group
• Balanced Mental Health of Arizona

  • Psychiatric/Mental Health Nurse Practitioner
  • Goodyear, AZ
  • NPI 1366211971
  Medicare reassignment NPD
• Desert View Counseling and Consulting, Inc.

  dba Desert View Counseling & Consulting

  • Mental Health Counselor
  • Peoria, AZ
  • NPI 1124173471

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Happy Ears Hearing Center

  • Audiologist-Hearing Aid Fitter
  • Peoria, AZ
  • NPI 1033516083
  NPD
• Lifeline Professional Counseling Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mesa, AZ
  • NPI 1023726866

  Psychiatric/Mental Health

  NPD (past)
• Lifeline Professional Counseling Services, Inc

  dba Lifeline East

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mesa, AZ
  • NPI 1194285643
  NPD (past)
• Lifeline Professional Counseling Services, Inc

  • Community/Behavioral Health Agency
  • Scottsdale, AZ
  • NPI 1235562463
  NPD (past)
• Lifeline Professional Counseling Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chandler, AZ
  • NPI 1285823377
  NPD (past)
• Lifeline Professional Counseling Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Avondale, AZ
  • NPI 1497229314
  NPD (past)

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1609583517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14122 W MCDOWELL RD STE 203",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952505",
            "telephone_number": "623-349-1711",
            "fax_number": "623-399-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14122 W MCDOWELL RD STE 203",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952505",
            "telephone_number": "623-349-1711",
            "fax_number": "623-399-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLEN",
        "first_name": "ROBERT",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-31",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "282633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #02243)
• Walgreen Co (Walgreens #03657)
• Walgreen Co (Walgreens #12386)
• Kiersten Walker, ED.S.
• Meredith Wall, DPT
• Walmart Inc. (Walmart Pharmacy 10-3604)
• Walmart Inc. (Walmart Pharmacy 10-5369)
• Walmart Stores, Inc. (Walmart Vision Center 30-5369)
• Aspyn Leeann Walters
• Chung Wang, MD

• Psychiatric/Mental Health Nurse Practitioner in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.