Healthcare Provider Details

I. General information

NPI: 1477484384
Provider Name (Legal Business Name): SKB THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 E 29TH ST STE 260
LOVELAND CO
80538-2743
US

IV. Provider business mailing address

295 E 29TH ST STE 260
LOVELAND CO
80538-2743
US

V. Phone/Fax

Practice location:
  • Phone: 970-239-1377
  • Fax: 970-573-7785
Mailing address:
  • Phone: 970-239-1377
  • Fax: 970-573-7785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE BAGWELL
Title or Position: PSYCHOLOGIST
Credential: PSY.D.
Phone: 773-559-8172