Individual provider Active NPI

Stephanie K Bagwell, PSY.D.

  • Clinical Psychologist
  • Fort Collins, CO
National Provider Identifier
1114368263
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY.0004599 Issued in CO
Practice address
2627 Redwing Rd Ste 220
Fort Collins, CO 80526-6331
Phone
(970) 239-1377
NPI assigned
Jul 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0004599 CO Primary

Addresses

Primary practice location

2627 Redwing Rd Ste 220
Fort Collins, CO 80526-6331

Mailing address

2627 Redwing Rd Ste 220
Fort Collins, CO 80526-6331
Phone (773) 559-8172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170630001933 CO Practitioner - Clinical Psychologist 4486965480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
SKB TherapyGroup PAC ID 6507295912, 3 clinicians

Practice addresses (Care Compare)

1256 22ND St SW
Loveland, CO 80537-7068
Phone (720) 507-7686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY.0004599COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
SKB Therapy CurrentSince Feb 19, 2020 Accepting new patients
Heart Centered Counseling, PC Clinical Current Accepting new patients
SKB Therapy CurrentSince Feb 19, 2020 Accepting new patients

Locations

2627 Redwing Rd
Ste 220
Fort Collins, CO 80526
Phone (970) 239-1377

320 W Olive St
Fort Collins, CO 80521
Phone (603) 361-7093

295 E 29th St
Ste 260
Loveland, CO 80538
Phone (970) 239-1377

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1114368263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 REDWING RD STE 220",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805266331",
            "telephone_number": "773-559-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 REDWING RD STE 220",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805266331",
            "telephone_number": "970-239-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGWELL",
        "first_name": "STEPHANIE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0004599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.