Active NPI
Dustin Godwin, LMSW
- Clinical Social Worker
- O'Fallon, MO
National Provider Identifier
1477389443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2024033725
- Practice address
- 801 S Woodlawn Ave Ste 15
O Fallon, MO 63366-7647 - Phone
- (636) 379-1779
- NPI assigned
- Sep 9, 2024
- Last updated
- Sep 9, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2024033725 | MO | Primary |
Addresses
Primary practice location
801 S Woodlawn Ave Ste 15
O Fallon, MO 63366-7647
Mailing address
345 Highgrove Place Dr
O Fallon, MO 63366-4384
Phone (314) 583-2705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024033725 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandhill Counseling and Consultation, LLC | Clinical | Current | Accepting new patients |
Locations
801 S Woodlawn Ave
Ste 15
O Fallon, MO 63366
Phone (636) 379-1779
Organizations & group practices 1
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.
-
- Marriage & Family Therapist
- O'Fallon, MO
- NPI 1992174759
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1477389443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 HIGHGROVE PLACE DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633664384",
"telephone_number": "314-583-2705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 S WOODLAWN AVE STE 15",
"city": "O FALLON",
"state": "MO",
"postal_code": "633667647",
"telephone_number": "636-379-1779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODWIN",
"first_name": "DUSTIN",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-09",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2024033725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in O'Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.