Individual provider Active NPI

Angelica Powelson, BCBA

  • Behavior Analyst
  • Englewood, CO
National Provider Identifier
1174167456
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-38638 Issued in TX
Practice address
325 Inverness Dr S
Englewood, CO 80112-6012
Phone
(720) 507-5226
Fax
(720) 368-5139
NPI assigned
Oct 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-19-38638 TX Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

325 Inverness Dr S
Englewood, CO 80112-6012

Mailing address

11341 Xavier Dr Unit 204
Westminster, CO 80031-6556
Phone (615) 429-8079

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

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1174167456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11341 XAVIER DR UNIT 204",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800316556",
            "telephone_number": "615-429-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 INVERNESS DR S",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801126012",
            "telephone_number": "720-507-5226",
            "fax_number": "720-368-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELSON",
        "first_name": "ANGELICA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-19-38638",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.