Individual
MS. ELOUISE 'ELLIE' A KNUTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LICSW
Contact information
Practice address
1535 110TH ST SE, KERKHOVEN, MN 56252-9564
(320) 220-2159
(320) 235-0099
Mailing address
1535 110TH ST SE, KERKHOVEN, MN 56252-9564
(320) 220-2159
(320) 235-0099
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11513
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011064700
DHS
MN
01
—
20519475456201A006
TRICARE WEST
MN
01
—
70L94KN
BCBSMN
MN
01
—
800002451
MEDICARE PTAN
MN
01
—
HP85447
HEALTH PARTNERS HPPID
MN
Enumeration date
01/31/2007
Last updated
01/31/2017
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