Provider Demographics
NPI:1578332078
Name:JOHNPULLE, ANUSHKA CHRISTINE (LCSW, ACM-SW)
Entity Type:Individual
Prefix:MRS
First Name:ANUSHKA
Middle Name:CHRISTINE
Last Name:JOHNPULLE
Suffix:
Gender:F
Credentials:LCSW, ACM-SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 UNIVERSITY DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3316
Mailing Address - Country:US
Mailing Address - Phone:813-789-5548
Mailing Address - Fax:
Practice Address - Street 1:1135 UNIVERSITY DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-3316
Practice Address - Country:US
Practice Address - Phone:813-789-5548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0070841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical