Provider Demographics
NPI:1891508727
Name:STROME, DANIEL L (SWC, MSW, BSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:STROME
Suffix:
Gender:M
Credentials:SWC, MSW, BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 N MAIN ST STE 330
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3047
Mailing Address - Country:US
Mailing Address - Phone:719-569-7909
Mailing Address - Fax:
Practice Address - Street 1:720 N MAIN ST STE 330
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3047
Practice Address - Country:US
Practice Address - Phone:719-569-7909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175T00000X
CO0000002400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No175T00000XOther Service ProvidersPeer Specialist