MR. KELLAN STACK, LCSW
Social Worker - Clinical
Active
Individual
NPI: 1114499811
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Social Worker - Clinical | 1041C0700X | Yes | CSW.09930278 (CO) |
Frequently Asked Questions
NPI 1114499811 is the National Provider Identifier for MR. KELLAN STACK, LCSW, a Social Worker - Clinical provider located in Evans, CO. This NPI was enumerated on December 19, 2018.
MR. KELLAN STACK, LCSW practices at 2441 SHOOTING STAR WAY, Evans, CO 80620.
Quick Facts
- NPI
- 1114499811
- Type
- Individual
- Enumerated
- Dec 19, 2018
- Last Updated
- Jul 1, 2025
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