Alexis Nicole Jacobson, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

30219 Issued in MN

Practice address

1148 Shoreview Rd
Two Harbors, MN 55616-5011

Phone

(218) 220-7845

NPI assigned

Dec 6, 2021

Last updated

Jul 25, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Two Rivers Counseling LLCGroup PAC ID 7416322268, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Two Rivers Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Duluth, MN
  • NPI 1093486722
  Medicare reassignment Care Compare group NPD
• Soaring Eagles Therapy LLC

  • Clinical Social Worker
  • Two Harbors, MN
  • NPI 1538080320
  NPD (past) Authorized official

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784937600000",
    "number": "1083372106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 SHOREVIEW RD",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556165011",
            "telephone_number": "218-595-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1148 SHOREVIEW RD",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556165011",
            "telephone_number": "218-220-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ALEXIS",
        "middle_name": "NICOLE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-06",
        "last_updated": "2026-07-25",
        "certification_date": "2026-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "30219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Ann Hellman
• Lucas Thor Henningsen, MD
• Nicole Anne Humes, RDH
• Daniel Walter Iverson, D.D.S.
• Elaine Mae Jackson
• Jane Wolf Speech and Feeding Therapy LLC
• John W. Pepelnjak Chiropractic Clinic, Inc.
• Tracy Jones, PHARMD
• Howard Y Josephs, M.D.
• Amy Jouppi, PT

• Mental Health Counselor in Two Harbors, MN
• Providers in Two Harbors, 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 Jul 25, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.