Randall R Godwin, M.ED., LIAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LIAC-11869 Issued in AZ

Practice address

20 E Thomas Rd Ste 2200
Phoenix, AZ 85012-3133

Phone

(844) 843-7279

NPI assigned

Sep 24, 2009

Last updated

Jun 11, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

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.

• Mavie LLC

  • Family Medicine Physician
  • La Pine, OR
  • NPI 1366270365

  Addiction (Substance Use Disorder), AZ

  Medicare reassignment NPD

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1205160108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 E CHANDLER BLVD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852259456",
            "telephone_number": "623-499-8917",
            "fax_number": "602-926-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E THOMAS RD STE 2200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123133",
            "telephone_number": "844-843-7279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2375 E Camelback Rd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850163493",
            "country_code": "US",
            "telephone_number": "888-711-5993",
            "fax_number": "888-711-6216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODWIN",
        "first_name": "RANDALL",
        "middle_name": "R",
        "credential": "M.ED., LIAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-24",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LIAC-11869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204317",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ishan Godra, D.O.
• Varshita Goduguchinta, DO
• Ebony Boswell Godwin
• Matthew Godwin
• Patrick Godwin
• IV Godzdanker, M.D.
• Laura Danielle Goedhart, DPT
• Breanne Francine Goegan, PAC
• Parul Bansal Goel, M.D.
• Shashi Jain Goel, MD PC INC

• Addiction (Substance Use Disorder) Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.