Spectrum Therapy, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SPECTRUM THERAPY, PLLC

Practice address

2441 Shooting Star Way
Evans, CO 80620-9243

Phone

(970) 236-1798

NPI assigned

Dec 16, 2025

Organization subpart

No

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

Authorized official

Name

Kellan StackNPI 1114499811

Title

Owner

Phone

(970) 689-6388

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kellan Jace Stack, LCSW

  • Clinical Social Worker
  • Evans, CO
  • NPI 1114499811
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1765843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1912861642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 SHOOTING STAR WAY",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806209243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 SHOOTING STAR WAY",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806209243",
            "telephone_number": "970-236-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-16",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "STACK",
        "authorized_official_first_name": "KELLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-689-6388"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikki Montoya Sides, MD
• Lauren Marie Siewert, PA-C
• Ximena Sifuentes
• Ciani Kate Sosa, FNP
• David James Sosa
• Kellan Jace Stack, LCSW
• April Stengel, PA-C
• Haylie Leann Stoltz, BA
• Sunrise Community Health
• Sunrise Community Health

• Clinical Social Worker in Evans, CO
• Providers in Evans, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.