Healthcare Provider Details

I. General information

NPI: 1023976495
Provider Name (Legal Business Name): VICTORIA STORM MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 PATTON ST
FORT COLLINS CO
80524-4018
US

IV. Provider business mailing address

4856 INNOVATION DR
FORT COLLINS CO
80525-5539
US

V. Phone/Fax

Practice location:
  • Phone: 970-494-4200
  • Fax:
Mailing address:
  • Phone: 970-494-4200
  • Fax: 844-270-1824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0024438
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: