Colleen Etzbach, RHD, LPC
Individual provider Active NPI Professional Counselor · Wabasha, MN
NPI 1326560889 · NPPES record last updated Nov 22, 2024
Key facts
- NPI
- 1326560889
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- CC03123 (MN)
- Practice address
- 145 2ND St W
Wabasha, MN 55981-1245 - Phone
- (715) 279-8591
- NPI assigned
- Jul 16, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC03123 | MN | MD | Professional Counselor |
| 5537 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beacon Mental Health Resources LLC | Current |
Accepting new patients | |
| Cosan Leighis LLC | Professional | Current |
Accepting new patients |
Locations
145 2nd St W
Wabasha, MN 55981
Phone (651) 565-3687
1421 Broadway St N
Ste 114B
Menomonie, WI 54751
Phone (715) 308-5742
393 Red Cedar St
Ste 3
Menomonie, WI 54751
Phone (715) 308-3871
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 5537 | WI | |
| Professional Counselor | 101YP2500X | CC03123 | MN | Yes |
Addresses
Primary practice location
145 2ND St W
Wabasha, MN 55981-1245
Mailing address
145 2ND St W
Wabasha, MN 55981-1245
Phone (715) 279-8591
Other practice location 1
1421 Broadway St N Ste 114B
Menomonie, WI 54751-4728
Phone (715) 308-5742
Other providers in Wabasha, MN
- Crossroads Behavioral Health, P.L.C.
- Jeffrey Darling
- Thomas Edward Dudley
- Scott Holt Durand
- Eagle Valley Chiropractic LLC
- Zachary Christopher Evans
- Mary Lou Fellows
- Carol Ann Groth
- Kinsley Sara Hackman
- Marc J. Hampl
All providers in Wabasha, MN · Professional Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.