EDEN BROBERG MA NPI 1265190474

NPI Information

NPI: 1265190474
Provider Name: EDEN BROBERG, MA
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
6381 OSGOOD AVE N BLDG C
STILLWATER, MN
ZIP 55082
Phone: (651) 401-8162
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Eden Broberg, MA is a mental health counselor in Stillwater, MN. Eden Broberg, MA NPI is 1265190474. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6381 OSGOOD AVE N BLDG C
STILLWATER, MN
ZIP 55082-118
Phone: (651) 401-8162
Fax: (651) 383-4544

The enumeration date for this NPI number is 12/5/2021 and was last updated on 5/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program			MINNESOTA	No
2	101YM0800X	Counselor	Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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