Provider Demographics
NPI:1104527696
Name:KNUTSON, ELENA ALBERTA (LCSW)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:ALBERTA
Last Name:KNUTSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15002 WOLF BRANCH CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5969
Mailing Address - Country:US
Mailing Address - Phone:832-984-7871
Mailing Address - Fax:
Practice Address - Street 1:17510 HUFFMEISTER RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-6785
Practice Address - Country:US
Practice Address - Phone:832-984-7871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX688251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical