Individual provider Active NPI

Jacob Thomas Minnig, MA, LPCC, LADC

  • Professional Counselor
  • Eagan, MN
National Provider Identifier
1114660966
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4325 Issued in MN
Practice address
1471 Highview Ave
Eagan, MN 55121-1143
Phone
(651) 233-8379
NPI assigned
Apr 19, 2022
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 305842 MN
Mental Health Counselor 101YM0800X 04325 MN
Professional Counselor 101YP2500X 4325 MN Primary

Addresses

Primary practice location

1471 Highview Ave
Eagan, MN 55121-1143

Mailing address

1471 Highview Ave
Eagan, MN 55121-1143

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240520000669 MN Practitioner - Mental Health Counselor 4284075466 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
305842MNMDAddiction (Substance Use Disorder) Counselor
04325MNMDMental Health Counselor
4325MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Cities Recovery Gym & Wellness Center LLC Addiction (Substance Use Disorder) CurrentSince Mar 5, 2024 Accepting new patients
Behavioral Health Integration Addiction (Substance Use Disorder) CurrentSince Apr 24, 2022 Accepting new patients
Northstar Regional Past Accepting new patients
Northstar Regional Past Accepting new patients

Locations

2912 N 2nd St
Minneapolis, MN 55411
Phone (612) 234-4242

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1114660966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1471 HIGHVIEW AVE",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 HIGHVIEW AVE",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211143",
            "telephone_number": "651-233-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNIG",
        "first_name": "JACOB",
        "middle_name": "THOMAS",
        "credential": "MA, LPCC, LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-19",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305842",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "04325",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "4325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.