Mr. Kellan Jace Stack, LCSW
Mr. Kellan Jace Stack is a Clinical Social Worker provider (Social Worker) practicing in Evans, CO, registered in the NPPES registry with NPI 1114499811 since 2018. The credential LCSW stands for Licensed Clinical Social Worker. Practices at Spectrum Therapy, Pllc (listed at the same practice address in NPPES).
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1114499811 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Mr. Kellan Jace Stack |
| Credential | LCSW |
| Sex | Female |
| Practice address | 2441 SHOOTING STAR WAY, Evans, CO, 80620 |
| Phone | 9706896388 |
| Enumeration date | 2018-12-19 |
| Last updated in NPPES | 2025-07-01 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 1041C0700X | Clinical Social Worker | Primary | CSW.09930278 | CO |
LCSW — Licensed Clinical Social Worker: A social worker licensed for clinical practice including mental-health therapy. About the LCSW credential
Copy-ready billing details
Provider: Kellan Stack, LCSW NPI: 1114499811 Taxonomy: 1041C0700X (Clinical Social Worker) Address: 2441 SHOOTING STAR WAY, Evans, CO, 80620
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1912861642 | Spectrum Therapy, Pllc | Organization | Clinical Social Worker | Evans, CO |
Verify this record
Cross-check NPI 1114499811 against the authoritative CMS record: view Mr. Kellan Jace Stack on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-07-01.