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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. KELLAN JACE STACK, LCSW

Active

Clinical Social Worker · EVANS, CO

Registration Details

NPI Number
1114499811
Provider Type
Individual
Gender
Female
NPI Issued
Dec 19, 2018 (7.336062608069 yrs)
Last Updated
Jul 1, 2025
License
CSW.09930278 (CO)

Practice Information

Address
2441 SHOOTING STAR WAY
EVANS, CO, 806209243
Browse CO providers · Browse ZIP 80620
Phone
9706896388
Primary Specialty
Clinical Social Worker
1041C0700X

Other Clinical Social Worker Providers in EVANS, CO

Name Credential NPI
MARIA S DIAZ LCSW, CAC III 1588769335
PAULETTE TARNASKY LCSW 1932293354
JENNIFER L MILLER LCSW 1386040871
ESTHER AGUILA MSW 1063806685
MRS. YARICZA EMMA CASTANEDA MSW, LCSW 1750050258
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.