MR. SCOTT BROBERG (NPI# 1063755635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063755635 |
| Entity Type | Individual |
| Full Name | MR. SCOTT BROBERG |
| Credential | LCSW |
| Practice Address |
265 E Chubbuck Road Chubbuck ID 83202 |
| Practice Telephone | 2082371711 |
| Practice Fax Number | 2082379806 |
| Mailing Telephone | 2082371711 |
| Mailing Fax Number | 2082379806 |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2020-11-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW-40120 | ID | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
LMSW-32675 | ID | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003822727 | Scott A Broberg | Pediatrics | 3816 S.1st St., Austin, TX 78704-7048 | 2006-08-01 |
| Street Address |
265 E CHUBBUCK ROAD |
| City | CHUBBUCK |
| State | ID |
| Zip Code | 83202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376965509 | Shawn Peter Parmanand | Counselor | 265 E Chubbuck Road, Chubbuck, ID 83202 | 2014-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700379682 | Vera Whole Health, Wa PC | Clinic/Center | 219 Phil Meador Ave, Pocatello, ID 83202 | 2018-06-14 |
| 1649712597 | Angie M Mccurdy | Audiologist | 4155 Yellowstone Hwy, Pine Ridge Mall, Pocatello, ID 83202 | 2016-11-09 |
| 1285180836 | Beverly Grigg Jones | Counselor | 210 W. Burnside, Chubbuck, ID 83202 | 2016-09-01 |
| 1376992503 | Andrea Walsh | Nurse Practitioner | 1133 Call Creek Dr, Ste A, Pocatello, ID 83202 | 2016-06-08 |
| 1215381181 | Specialized Physical Therapy Pllc | Clinic/Center | 4141 Poleline Rd Ste A, Pocatello, ID 83202 | 2016-04-18 |
| 1457713588 | Jennifer Ann Gould | Radiologic Technologist | 907 Ryan Street, Chubbuck, ID 83202 | 2016-03-28 |
| 1154714897 | Phoenix Management LLC | Day Training, Developmentally Disabled Services | 10991 Deerridge Dr., Chubbuck, ID 83202 | 2015-03-05 |
| 1750781449 | Jennifer Lynn Seaich | Counselor | 4460 Center Way, Center Counseling, Pocatello, ID 83202 | 2014-08-29 |
| 1336562412 | Kurt Layton | Counselor | 337 Joel, Chubbuck, ID 83202 | 2014-01-27 |
| 1245653468 | Hannah's Place LLC | Occupational Therapist | 240 W Burnside Ave Ste D, Chubbuck, ID 83202 | 2014-01-23 |
| Find all providers in zip 83202 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104374974 | Center Counseling, LLC | Social Worker | 265 East Chubbuck, Chubbuck, ID 83202-5055 | 2016-09-21 |
| 1093177719 | Deanna Sue Smith | Social Worker | 265 E Chubbuck Rd Ste A, Chubbuck, ID 83202-5055 | 2016-03-22 |
| 1548585458 | Mental Health Specialists | Social Worker | 210 W Burnside Ave, Suite A, Chubbuck, ID 83202-4916 | 2010-04-02 |
| 1568798106 | Teresa K Belnap-hazen | Social Worker | 445 W Chubbuck Rd Ste C, Chubbuck, ID 83202-5069 | 2009-11-01 |
| 1801335633 | Shellie Waterman | Social Worker | 210 W Burnside Ave, Suite A, Chubbuck, ID 83202-4916 | 2017-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171961 | Jill Michelle Chonody | Social Worker | 3134 S Waterbury Ln, Boise, ID 83706-5222 | 2020-10-09 |
| 1750999777 | Deanna Armenia Brent | Social Worker | 7450 W Althea Ct, Boise, ID 83709-1777 | 2020-07-15 |
| 1164040820 | Sylinda Lee Mendenhall | Social Worker | 771 S Jafer Court, Idaho Falls, ID 83401-8404 | 2020-07-09 |
| 1013533231 | Sylvia Oh | Social Worker | 2118 S Latah St, Boise, ID 83705-3947 | 2020-06-23 |
| 1073135851 | Kimberly Ruth Carey | Social Worker | 6160 Dallas Ln, Bonners Ferry, ID 83805-9794 | 2020-05-14 |
| 1497377469 | Raising Resilience Holistic Mental Wellness Inc | Social Worker | 610 W Hubbard St Ste 226, Coeur D Alene, ID 83814-2200 | 2020-05-13 |
| 1417577412 | Stacey Titus Pllc | Social Worker | 5440 W Franklin Rd Ste 201, Boise, ID 83705-6434 | 2020-04-20 |
| 1922627314 | Taresa Dawn Crow | Social Worker | 3655 Samuel St, Ammon, ID 83406-7822 | 2020-04-15 |
| 1447888656 | Berndt and Associates In Psychcare LLC | Social Worker | 4477 W Emerald St Ste C275, Boise, ID 83706-2078 | 2020-04-01 |
| 1467086603 | Abundant Serenity LLC | Social Worker | 925 N Main St Ste A, Meridian, ID 83642-2301 | 2020-02-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.