Cosan Leighis LLC

Key facts

NPI

1457066284

Entity type

Organization (NPI type 2)

Primary specialty

Professional Counselor 101YP2500X

Legal business name

COSAN LEIGHIS LLC

Practice address

145 2ND St W
Wabasha, MN 55981-1245

Phone

(715) 279-8591

NPI assigned

Jan 17, 2023

Organization subpart

No

Authorized official

Name

Dr. Colleen Etzbach, RHD NPI 1326560889

Title

Owner/Psychotherapist

Phone

(715) 279-8591

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Colleen Etzbach, RHD, LPC Professional Counselor · Wabasha, MN · NPI 1326560889
  NPD Authorized official PROFESSIONAL

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 15, 2024.

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1457066284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 2ND ST W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811245",
            "telephone_number": "715-279-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 2ND ST W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811245",
            "telephone_number": "715-279-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSAN LEIGHIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "ETZBACH",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "715-279-8591",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "RHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wabasha, MN

• Remington James Brisbois, DDS
• Susan J. Buck, FNP
• Brianna Byam
• Andrew Christensen, D.D.S.
• City of Wabasha
• County of Wabasha
• Crossroads Behavioral Health, P.L.C.
• Jeffrey Darling, PT
• Thomas Edward Dudley, M.D.
• Scott Holt Durand, DDS

All providers in Wabasha, MN · Professional Counselor in Minnesota