Provider Demographics
NPI:1841500352
Name:STROMGREN, DANIEL LONGLEY (LMSW-CC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:LONGLEY
Last Name:STROMGREN
Suffix:
Gender:M
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-4761
Mailing Address - Country:US
Mailing Address - Phone:207-591-4452
Mailing Address - Fax:207-887-7130
Practice Address - Street 1:201 MAIN ST
Practice Address - Street 2:SUITE 6
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-4761
Practice Address - Country:US
Practice Address - Phone:207-591-4452
Practice Address - Fax:207-887-7130
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC128141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical