Healthcare Provider Details

I. General information

NPI: 1306784038
Provider Name (Legal Business Name): CIRCLE PATH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 S BLACKHAWK ST STE 240
AURORA CO
80014-1475
US

IV. Provider business mailing address

2101 S BLACKHAWK ST STE 240
AURORA CO
80014-1475
US

V. Phone/Fax

Practice location:
  • Phone: 720-468-9654
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KYLE EVAN BACON
Title or Position: OWNER/LICENSED PSYCHOLOGIST
Credential: PSYD, LP, BCBA, NCSP
Phone: 720-468-9654