DR. COLLEEN ETZBACH (NPI# 1326560889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326560889 |
| Entity Type | Individual |
| Full Name | DR. COLLEEN ETZBACH |
| Credential | RHD, LPC |
| Practice Address |
1421 Broadway St N Ste 114b Menomonie WI 54751-4728 |
| Practice Telephone | 7153085742 |
| Practice Fax Number | 8889724831 |
| Mailing Telephone | 7153085742 |
| Mailing Fax Number | 8889724831 |
| Enumeration Date | 2017-07-16 |
| Last Update Date | 2020-08-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
5537 | WI | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 393 Red Cedar St Ste 3, Menomonie, WI 547512267 | (715) 308-5742 | 8889724831 |
| Street Address |
1421 BROADWAY ST N STE 114B |
| City | MENOMONIE |
| State | WI |
| Zip Code | 54751-4728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518241876 | Rebecca Hustad | Marriage & Family Therapist | 1421 Broadway St N Ste 114b, Menomonie, WI 54751-4728 | 2011-10-05 |
| 1710549183 | Shae Marie Havner | Social Worker | 1421 Broadway St N Ste 114b, Menomonie, WI 54751-4728 | 2019-07-05 |
| 1518529981 | Jeffrey Coleman Lund | Counselor | 1421 Broadway St N Ste 114b, Menomonie, WI 54751-4728 | 2019-07-05 |
| 1407379787 | Beacon Mental Health Resources LLC | Marriage & Family Therapist | 1421 Broadway St N Ste 114b, Menomonie, WI 54751-4728 | 2017-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154840569 | Ashley Friedenfels | Physical Medicine & Rehabilitation | E4486 290th Avenue, Menomonie, WI 54751 | 2017-09-18 |
| 1215307814 | David Calvin Reimann | Hearing Instrument Specialist | E4584 483rd Avenue, Menomonie, WI 54751 | 2015-09-25 |
| 1790128627 | County of Dunn | Skilled Nursing Facility | 651 Howison Circle, Menominie, WI 54751 | 2013-04-10 |
| 1043653983 | County of Dunn | Skilled Nursing Facility | 658 Howison Circle, Menomonie, WI 54751 | 2013-04-10 |
| 1447519236 | Gentle Dental Care LLC | Dentist | 1813 Wilson St., Menomonie, WI 54751 | 2012-05-14 |
| 1386960193 | Kilimanjaro LLC | Non-emergency Medical Transport (VAN) | 1222 14th Ave E, Menomonie, WI 54751 | 2010-04-19 |
| 1275709180 | Dianne Marie Bennett | Counselor | 1916 2nd St W, Menomonie, WI 54751 | 2008-05-01 |
| 1417136201 | David Gary Hackbarth | Chiropractor | 3120 Schneider Ave E, Suite #5, Menomonie, WI 54751 | 2007-10-29 |
| 1306057336 | Tonia D. Behling | Dental Hygienist | 3375 Kothlow Ave., Suite 40, Menomonie, WI 54751 | 2007-05-24 |
| 1295956282 | Danny Roger Wood | Dentist | 1603 Stout Rd, Menomonie, WI 54751 | 2007-05-01 |
| Find all providers in zip 54751 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336619097 | Jessica Kleist | Counselor | N4572 446th St, Menomonie, WI 54751-5453 | 2018-11-26 |
| 1235466921 | Loriann Barcus | Counselor | N4762 State Road 25, Menomonie, WI 54751-7414 | 2009-11-17 |
| 1356973085 | Chelsea Ann Morgan | Counselor | 700 Wolske Bay Rd Ste 140, Menomonie, WI 54751-1679 | 2020-02-11 |
| 1518529981 | Jeffrey Coleman Lund | Counselor | 1421 Broadway St N Ste 114b, Menomonie, WI 54751-4728 | 2019-07-05 |
| 1316415888 | Nathaniel A Mckeefry | Counselor | 402 Technology Dr E, Menomonie, WI 54751-2370 | 2018-11-02 |
| 1396251013 | Santana Rae Stauty | Counselor | 3001 Us Highway 12 E Ste 160, Menomonie, WI 54751-3045 | 2017-12-18 |
| 1003274770 | Annelies Luellen White | Counselor | 2919 Stout Rd, Menomonie, WI 54751-2313 | 2016-02-09 |
| 1588900872 | Erin K Johnson | Counselor | 406 Technology Dr E, Suite C, Menomonie, WI 54751-2767 | 2012-12-14 |
| 1801105341 | Amanda Marie Thomas Evans | Counselor | 808 Main St E, Menomonie, WI 54751-2735 | 2010-10-01 |
| 1639119951 | Sylvia E Piekarz | Counselor | 808 Main St E, Menomonie, WI 54751-2735 | 2006-06-07 |
| Find all providers in MENOMONIE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.