Provider Demographics
NPI:1417577172
Name:ANUSZEK, JOELLE (BCBA)
Entity Type:Individual
Prefix:
First Name:JOELLE
Middle Name:
Last Name:ANUSZEK
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:JOELLE
Other - Middle Name:
Other - Last Name:COLELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1050 S ACADEMY BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3922
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1050 S ACADEMY BLVD STE 140
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3922
Practice Address - Country:US
Practice Address - Phone:719-684-6514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-20-116034106S00000X
CO1-23-65238103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician