Healthcare Provider Details

I. General information

NPI: 1891508727
Provider Name (Legal Business Name): DANIEL L STROME LAC, SWC, MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33550 E STATE HIGHWAY 96 LOT 64
PUEBLO CO
81001-6023
US

IV. Provider business mailing address

33550 E STATE HIGHWAY 96 LOT 64
PUEBLO CO
81001-6023
US

V. Phone/Fax

Practice location:
  • Phone: 719-281-9961
  • Fax:
Mailing address:
  • Phone: 719-281-9961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0000002400
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0002784
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: