MEDICARE: RODEN BEHAVIORAL HEALTH, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1962097071
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RODEN BEHAVIORAL HEALTH, PLLC

Provider Business Mailing Address
First Line	:	4700 S FULTON RANCH BLVD UNIT 19
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85248-5030
Country	:	US
Telephone Number	:	480-521-7605
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 S FULTON RANCH BLVD UNIT 19
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85248-5030
Country	:	US
Telephone Number	:	480-521-7605
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	ROBERT RODEN
Credential	:	PHD
Telephone Number	:	480-899-8474

Provider Enumeration Date	:	03/02/2021
Last Update Date	:	12/08/2025

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