MIA ELISE BROBERG (NPI# 1720509813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720509813 |
| Entity Type | Individual |
| Full Name | MIA ELISE BROBERG |
| Practice Address |
1595 Cottage St Ne Salem OR 97301 |
| Mailing Address |
1715 Chemawa Rd. Ne Keizer OR 97303 |
| Practice Telephone | 5038971289 |
| Mailing Telephone | 5033838061 |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2017-06-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
1595 COTTAGE ST NE |
| City | SALEM |
| State | OR |
| Zip Code | 97301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700155538 | Vanessa Anne Underwood | Nurse Practitioner | 1595 Cottage St Ne, Salem, OR 97301-7123 | 2011-12-22 |
| 1003331943 | Thomas Wilson Dooley | Counselor | 1595 Cottage St Ne, Salem, OR 97301-7123 | 2017-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447866892 | Jennifer Thompson Worley | Counselor | 524 Mendham Way, Salem, VA 24153-2141 | 2020-09-21 |
| 1982221966 | Sierra Noelle Williams | Counselor | 3867 Wolverine St Ne Bldg F, Salem, OR 97305-4266 | 2020-06-25 |
| 1326660267 | Leslie Marie Adams | Counselor | 35 Congress St #214, Salem, MA 01970 | 2020-05-14 |
| 1821610304 | Healthy Connections Counseling, LLC | Counselor | 2640 Portland Rd Ne, Salem, OR 97301-0125 | 2020-05-07 |
| 1396366118 | Stephanie Ann Hunt | Counselor | 4 Waters St, Salem, MA 01970-3965 | 2020-05-04 |
| 1497381750 | Hyun Mok Samuel Kang | Counselor | 35 Congress St Ste 351a, Salem, MA 01970-5567 | 2020-03-19 |
| 1780223610 | Josette Thompson | Counselor | 11 Boston St, Salem, MA 01970-2103 | 2019-12-23 |
| 1801435870 | Sarah Katherine Bolte | Counselor | 35 Congress St., Bldg. 2 Suite 351a, Salem, MA 01970 | 2019-12-23 |
| 1871131201 | Silver Falls Trauma Recovery, LLC | Counselor | 495 State St Ste 540, Salem, OR 97301-3297 | 2019-12-16 |
| 1285278713 | Anita-elaine Harris | Counselor | 4890 32nd Ave Se Bldg A, Salem, OR 97317-9350 | 2019-10-28 |
| Find all providers in SALEM | ||||
Please comment or provide details below to improve the information on MIA ELISE BROBERG.
| 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.