Amanda Joy Poulson, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

11829206 Issued in CO

Practice address

2525 S Wadsworth Blvd
Lakewood, CO 80227-3273

Phone

(720) 962-4555

NPI assigned

Jun 5, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1124510185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 N INSTITUTE ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033142",
            "telephone_number": "719-310-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S WADSWORTH BLVD",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802273273",
            "telephone_number": "720-962-4555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "512 N Institute St",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809033142",
            "country_code": "US",
            "telephone_number": "719-310-5646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POULSON",
        "first_name": "AMANDA",
        "middle_name": "JOY",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "11829206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kelsey Lynn Powell
• Travis Joel Powell

• Behavior Analyst in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Behavior Analyst in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; 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.