MEDICARE: MR. GUYDELL M POWELL II

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	101Y00000X	Counselor	CO
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	CO
3	101YM0800X	Mental Health Counselor	CO

General Provider Information

NPI Number	:	1245188127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GUYDELL M POWELL II

Provider Business Mailing Address
First Line	:	4003 S RIFLE CT
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80013-3274
Country	:	US
Telephone Number	:	303-587-3889
Fax Number	:

Provider Business Practice Location Address
First Line	:	4003 S RIFLE CT
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80013-3274
Country	:	US
Telephone Number	:	303-587-3889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/29/2026

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