Provider Demographics
NPI:1700771888
Name:KUNERTH, ELLIOTT (LGSW)
Entity type:Individual
Prefix:MR
First Name:ELLIOTT
Middle Name:
Last Name:KUNERTH
Suffix:
Gender:M
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 MILLER TRUNK HWY STE 214
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-4448
Mailing Address - Country:US
Mailing Address - Phone:218-727-3888
Mailing Address - Fax:
Practice Address - Street 1:1702 MILLER TRUNK HWY STE 214
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-4448
Practice Address - Country:US
Practice Address - Phone:218-727-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN328291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical