EDEN BROBERG MA NPI 1265190474

NPI Information

  • NPI: 1265190474
  • Provider Name: EDEN BROBERG, MA
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 6381 OSGOOD AVE N BLDG C
    STILLWATER, MN
    ZIP 55082
  • Phone: (651) 401-8162

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NPI Details

Eden Broberg, MA is a mental health counselor in Stillwater, MN with 6 years of experience. 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 NPI 1265190474 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

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
1390200000XStudent in an Organized Health Care Education/Training ProgramMINNESOTANo
2101YM0800XCounselorMental HealthYes

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: 11/21/2025

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