Individual provider Active NPI

Jennifer Joelle Jacobs, MS, LPC, NCC

  • Mental Health Counselor
  • Prosper, TX
National Provider Identifier
1467051201
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401015576 Issued in MI
Practice address
1320 Berkshire Lane
Unit 305
Prosper, TX 75078-3040
Phone
(469) 708-9197
NPI assigned
Oct 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401015576 MI Primary

Addresses

Primary practice location

1320 Berkshire Lane
Unit 305
Prosper, TX 75078-3040

Mailing address

1320 Berkshire Lane
Unit 305
Prosper, TX 75078-3040
Phone (616) 821-9047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240610002478 TX Practitioner - Mental Health Counselor 7416499108 Reassigns benefits to 1 organization
I20241129000066 MI Practitioner - Mental Health Counselor 7416499108 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6401015576MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince May 5, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1467051201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 BERKSHIRE LANE",
            "address_2": "UNIT 305",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783040",
            "telephone_number": "616-821-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 BERKSHIRE LANE",
            "address_2": "UNIT 305",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783040",
            "telephone_number": "469-708-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JENNIFER",
        "middle_name": "JOELLE",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401015576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.