Provider Demographics
NPI:1831816990
Name:FONSEKA, ANUSHKA RUSIRA (LPC, NCC)
Entity type:Individual
Prefix:MR
First Name:ANUSHKA
Middle Name:RUSIRA
Last Name:FONSEKA
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
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Mailing Address - Street 1:2314 N GRANDVIEW BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1675
Mailing Address - Country:US
Mailing Address - Phone:262-251-1112
Mailing Address - Fax:262-251-1113
Practice Address - Street 1:W156N8327 PILGRIM RD STE 300
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-3776
Practice Address - Country:US
Practice Address - Phone:262-251-1112
Practice Address - Fax:262-251-1113
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI10104-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional