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MR. KING RICHARD RANDELL LPC, CADAC, ICADC
NPI 1790095313
Counselor - Professional in Benson, AZ

Active since October 15, 2010PECOS Enrolled
590 S OCOTILLO AVE, BENSON, AZ 85602(520) 586-7080(520) 586-6104 Get Directions Write a Review

NPPES record last updated: October 15, 2010. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mr. King Richard Randell Lpc, Cadac, Icadc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KING RICHARD RANDELL LPC, CADAC, ICADC (NPI 1790095313) is an individual professional provider in Benson, Arizona, licensed in Arizona (LPC-1244) and active in the NPI registry since October 2010. He is enrolled in Medicare PECOS and is a graduate of Other (1988).

NPPES Registry Identity

NPI1790095313
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. KING RICHARD RANDELLCredential: LPC, CADAC, ICADC
Location Address590 S OCOTILLO AVEBenson, AZ 85602-6405
Mailing Address611 W Union StBenson, AZ 85602-6718 · (520) 586-0800 · Fax (520) 586-0116
Phone(520) 586-7080
Fax(520) 586-6104
Sole ProprietorYes
Medical School CMSOtherGraduated 1988
Enumeration DateOctober 15, 2010
✔ NPI 1790095313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in AZ · LPC-1244
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License CADAC-1607 (AZ), ICADC-122108 (AZ)
590 S OCOTILLO AVE, Benson, AZ 85602
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. King Richard Randell Lpc, Cadac, Icadc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8426514183
PECOS Enrollment IDI20260803000203
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show King Randell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pascua Yaqui Tribe
45 mi
Community/Behavioral Health
1775 W SAINT MARYS RD STE 115
Tucson, AZ 85745
  • Reassigned Medicare billing, Texas enrollment
  • 35 clinicians in this Medicare group
NPI 1194230672 (520) 879-5450

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MURRAY ELLIS LEIMSIEDER MA, LAC & CRC
Counselor (Mental Health)
590 S OCOTILLO AVE
BENSON, AZ 85602
Cochise County (520) 586-7080
RONALD E. BASIL LCSW, MSW
Social Worker (Clinical)
590 S OCOTILLO AVE
BENSON, AZ 85602
Cochise County (800) 586-7080
KIM ANDERSON GREENWOOD PNP, MS
Nurse Practitioner (Psychiatric/Mental Health)
590 S OCOTILLO AVE
BENSON, AZ 85602
Cochise County (520) 586-7080
ROBIN A. TOOLE MSW, LCSW
Social Worker (Clinical)
590 S OCOTILLO AVE
BENSON, AZ 85602
Cochise County (800) 586-7080
JENNIE ELISE MCMILLIAN LPC, MA
Counselor (Professional)
590 S OCOTILLO AVE
BENSON, AZ 85602
Cochise County (520) 586-7080

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is King Randell's NPI number?

The NPI number for King Randell is 1790095313. It was assigned to this individual provider in the NPPES registry on October 15, 2010.

Where is King Randell located?

King Randell practices at 590 S Ocotillo Ave, Benson, AZ 85602. The listed phone number is (520) 586-7080.

What is King Randell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is King Randell enrolled in Medicare?

Yes. King Randell is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for King Randell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), King Randell reassigns Medicare benefits to Pascua Yaqui Tribe (Tucson, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for King Randell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for King Randell was last updated on October 15, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.