Individual provider Active NPI

George W. Scudella, MSW

  • Mental Health Counselor
  • Canon City, CO
National Provider Identifier
1083673750
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
989952 Issued in CO
Practice address
615 N 15TH St
Canon City, CO 81212-2313
Phone
(719) 269-8338
Fax
(719) 269-9170
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 989952 CO Primary

Addresses

Primary practice location

615 N 15TH St
Canon City, CO 81212-2313

Mailing address

615 N 15TH St
Canon City, CO 81212-2313
Phone (719) 269-8338

Other identifiers 1

IdentifierTypeStateIssuer
07989957MedicaidCO

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
989952COMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1083673750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N 15TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122313",
            "telephone_number": "719-269-8338",
            "fax_number": "719-269-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N 15TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122313",
            "telephone_number": "719-269-8338",
            "fax_number": "719-269-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCUDELLA",
        "first_name": "GEORGE",
        "middle_name": "W.",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "989952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07989957",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.