MR. SCOTT BROBERG (LCSW) – Clinical Social Worker, NPI 1063755635

MR. SCOTT BROBERG (LCSW) is a healthcare provider. based in Chubbuck, Idaho. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. LMSW-32675 (ID). The NPI Number for MR. SCOTT BROBERG (LCSW) is 1063755635

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
MR. SCOTT BROBERG (LCSW)
NPI
1063755635
Phone
(208) 237-1711
Address
265 E CHUBBUCK ROAD
Enumeration Date
2 April 2013
Last Update Date
3 November 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2082371711
Graduation Year
2012 (14 years ago)
PAC ID
3577700384
Group Practice PAC ID
6709165442
Professional Enrollment ID
I20130515000686
Address ID
ID832025055CH265XXRDXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:13State licenses:2Digital endpointsOther names

633 CLINICAL SOCIAL WORKER in ID

Provider Addresses for MR. SCOTT BROBERG (LCSW)

  • 265 E CHUBBUCK ROAD

    CHUBBUCK, ID 83202

    Phone: (208) 237-1711

    Fax: (208) 237-9806

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-05-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130515000686IClinical Social WorkerIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83202)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709165442View full group profile
NameSpecialtyState
Physician AssistantID
Mental Health CounselorID
Mental Health CounselorID
Mental Health CounselorID
Clinical Social WorkerID
Mental Health CounselorID
Clinical Social WorkerID
Mental Health CounselorID
Mental Health CounselorID
Mental Health CounselorOR

Reviews

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Frequently asked questions

Can I cross-check MR. SCOTT BROBERG (LCSW) using NPI 1063755635?
NPI 1063755635 belongs to MR. SCOTT BROBERG (LCSW); compare other details if you need extra assurance.
Would MR. SCOTT BROBERG (LCSW) appear as active to a payer?
You can treat MR. SCOTT BROBERG (LCSW) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is MR. SCOTT BROBERG (LCSW)?
MR. SCOTT BROBERG (LCSW) is associated with Clinical Social Worker in the directory — Clinical services aligned with this taxonomy classification.
Is MR. SCOTT BROBERG (LCSW) associated with Chubbuck?
Public fields place MR. SCOTT BROBERG (LCSW) around Chubbuck, Idaho. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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