Provider Demographics
NPI:1750552196
Name:LEITSCHUH, SARAH BISSON (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:BISSON
Last Name:LEITSCHUH
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 240711
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-0711
Mailing Address - Country:US
Mailing Address - Phone:952-457-2322
Mailing Address - Fax:
Practice Address - Street 1:4590 SCOTT TRL
Practice Address - Street 2:SUITE 200
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3331
Practice Address - Country:US
Practice Address - Phone:952-457-2322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1771106H00000X
MNLMFT#1771106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist