Provider Demographics
NPI:1053051235
Name:ACHARYA, AYUSHI (LCSW)
Entity Type:Individual
Prefix:
First Name:AYUSHI
Middle Name:
Last Name:ACHARYA
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 1:97 ROUND POND DR
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-9913
Mailing Address - Country:US
Mailing Address - Phone:678-848-7815
Mailing Address - Fax:
Practice Address - Street 1:2345 N HOUSTON ST APT 608
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-7633
Practice Address - Country:US
Practice Address - Phone:678-848-7815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX684021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical