Healthcare Provider Details

I. General information

NPI: 1336639822
Provider Name (Legal Business Name): CHRISTOPHER JOHN POWELL BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14139 W 89TH LOOP
ARVADA CO
80005-1301
US

IV. Provider business mailing address

17322 PAOLI WAY
PARKER CO
80134-7539
US

V. Phone/Fax

Practice location:
  • Phone: 720-375-4680
  • Fax:
Mailing address:
  • Phone: 248-420-8087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89534
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: