Provider Demographics
NPI:1821704024
Name:SHKURTI, ELED (LMSW LCDC)
Entity Type:Individual
Prefix:MR
First Name:ELED
Middle Name:
Last Name:SHKURTI
Suffix:
Gender:M
Credentials:LMSW LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16734 THORN CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4179
Mailing Address - Country:US
Mailing Address - Phone:713-894-3107
Mailing Address - Fax:
Practice Address - Street 1:16734 THORN CYPRESS DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4179
Practice Address - Country:US
Practice Address - Phone:713-894-3107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104319104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker