Eden Broberg, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

6381 Osgood Ave N BLDG C
Stillwater, MN 55082-6118

Phone

(651) 401-8162

Fax

(651) 383-4544

NPI assigned

Dec 5, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wholehearted Healing LLC

  • Mental Health Counselor
  • Wayzata, MN
  • NPI 1255934196
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1265190474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6381 OSGOOD AVE N BLDG C",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826118",
            "telephone_number": "651-401-8162",
            "fax_number": "651-383-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6381 OSGOOD AVE N BLDG C",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826118",
            "telephone_number": "651-401-8162",
            "fax_number": "651-383-4544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5354 Parkdale Dr Fl 2",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554161603",
            "country_code": "US",
            "telephone_number": "651-645-5323 x1449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROBERG",
        "first_name": "EDEN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-05",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Kosiapo Breiwick, CNP
• Bridge Pca, Inc.
• Bridgeview Chiropractic, P.a.
• Lindsay Beth Briggs, DC
• Thomas Broback, DPT, CSCS
• Patrick John Brod, MD
• Beth Ann Bronski, OTR
• Lucy Brooks, MA
• Melissa Brown
• Amy M Browning, DDS

• Mental Health Counselor in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.