Healthcare Provider Details

I. General information

NPI: 1821465758
Provider Name (Legal Business Name): DERRICK R STONECIPHER MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2015
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10136 POUDRE CANYON RD
BELLVUE CO
80512-7516
US

IV. Provider business mailing address

10136 POUDRE CANYON RD
BELLVUE CO
80512-7516
US

V. Phone/Fax

Practice location:
  • Phone: 970-430-3296
  • Fax:
Mailing address:
  • Phone: 970-430-3296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0014575
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: