Individual ProviderEden BrobergCounselorBehavioral Health & Social Service ProvidersPractice Address6381 Osgood Ave N Bldg C, Stillwater, MN 55082-6118(651) 401-8162PECOS EnrollmentBased on the most recent information from CMS, provider Eden Broberg is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1265190474Provider TypeIndividualFull NameBroberg, EdenCredentialMAGenderFemaleSole ProprietorYesEnumeration Date12/5/2021Last Updated5/11/2023Contact InformationPractice LocationPractice Address6381 Osgood Ave N Bldg C, Stillwater, MN 55082-6118Phone(651) 401-8162Fax(651) 383-4544Mailing LocationMailing Address6381 Osgood Ave N Bldg C, Stillwater, MN 55082-6118Phone(651) 401-8162Fax(651) 383-4544Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerMinnesota