Healthcare Provider Details

I. General information

NPI: 1336962794
Provider Name (Legal Business Name): STEPHANIE BICKEL MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEPHANIE HAWK MA

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11689 AVENA RD
PEYTON CO
80831-6885
US

IV. Provider business mailing address

11689 AVENA RD
PEYTON CO
80831-6885
US

V. Phone/Fax

Practice location:
  • Phone: 720-549-0515
  • Fax:
Mailing address:
  • Phone: 719-650-8092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0021401
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: