MEDICARE: MICHAEL P GOODRICH

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	101YA0400X	Addiction (Substance Use Disorder) Counselor		AZ

General Provider Information

NPI Number	:	1477405223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL P GOODRICH

Provider Business Mailing Address
First Line	:	PO BOX 1291
Second Line	:
City	:	BUCKEYE
State	:	AZ
Zip	:	85326-0096
Country	:	US
Telephone Number	:	602-694-9923
Fax Number	:

Provider Business Practice Location Address
First Line	:	6500 S MILLER RD BLDG C
Second Line	:
City	:	BUCKEYE
State	:	AZ
Zip	:	85326-1503
Country	:	US
Telephone Number	:	602-694-9923
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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Directions to “ MICHAEL P GOODRICH ” Practice Location

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