Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1114499811 Individual Practitioner Female Practitioner

Kellan Jace Stack , LCSW

Social Worker - Clinical • Evans, CO

Professional Overview & Biography Verified Profile Summary

Kellan Stack, LCSW is a certified Social Worker - Clinical practicing in Evans, CO. With approximately 8 years of clinical experience since completing medical education in 2018, Kellan Stack delivers high-quality medical care to the local community at 2441 SHOOTING STAR WAY.

Kellan Stack does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

2441 Shooting Star Way

Evans, CO 806209243

Telephone 9706896388
Associated Practice Facility / Clinic
🏢 Spectrum Therapy, Pllc Facility NPI 1912861642

Medicare Profile & Education

Medical School

Other

Graduation Year

2018

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Social Worker - Clinical in Evans, CO

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
8 Yrs -6.5 yrs vs City Avg
City Avg: 14.5 Yrs
State Avg: 17.4 Yrs
Regional Practice Density
6 Specialists

Practicing in Evans, CO (7500 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Stack (8 Years) 8 Yrs
Evans Specialty Average (14.5 Years) 14.5 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-07-01
Social Worker - Clinical Primary Specialty

NUCC Taxonomy Code: 1041C0700X

State License CO CSW.09930278

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
👤
Provider Name / Credentials Updated July 01, 2025

Recorded as KELLAN STACK, LCSW

📍
Updated Practice Location March 22, 2024

Registered at 2441 SHOOTING STAR WAY, EVANS, CO 806209243 (Tel: 9706896388)

📍
Updated Business Mailing Address March 22, 2024

Registered at 2441 SHOOTING STAR WAY, EVANS, CO 806209243 (Tel: 9706896388)

👤
Provider Name / Credentials Updated March 22, 2024

Recorded as ALYCIA STACK, LCSW

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 22, 2024

Social Worker (License #CSW.09930278 in CO)

NPI Profile Active December 19, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location December 19, 2018

Registered at 1808 DILMONT AVE, GREELEY, CO 806316207 (Tel: 9706896388)

📍
Updated Business Mailing Address December 19, 2018

Registered at 1808 DILMONT AVE, GREELEY, CO 806316207 (Tel: 9706896388)

👤
Provider Name / Credentials Updated December 19, 2018

Recorded as ALYCIA ERICKSON, MSW

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 19, 2018

Counselor

🟢
Initial NPI Registration & Enumeration December 19, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114499811
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 19, 2018
Last Update: July 01, 2025
Sole Proprietor: No

Mailing Address

2441 Shooting Star Way

Evans, CO 806209243

Phone: 9706896388

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.