Individual provider Active NPI

Dirk Magdahl Jakob, PHD

  • Professional Counselor
  • San Antonio, TX
National Provider Identifier
1487689998
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
11324 Issued in TX
Practice address
12050 Vance Jackson Rd Ste 201
San Antonio, TX 78230-1183
Phone
(210) 699-8881
Fax
(210) 699-0503
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 11324 TX Primary

Addresses

Primary practice location

12050 Vance Jackson Rd Ste 201
San Antonio, TX 78230-1183

Mailing address

12050 Vance Jackson Rd
BLDG. 2 Suite 201
San Antonio, TX 78230-1182
Phone (210) 699-8881

Other names 1

  • Dirk Magdahl Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240222000101 TX Practitioner - Mental Health Counselor 4688018211 Practice locations: San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12050 Vance Jackson Rd
BLDG.2 Suite 201
San Antonio, TX 78230-1183

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
11324TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
STBM LLC CurrentSince Nov 26, 2023 Accepting new patients

Locations

12050 Vance Jackson Rd
Ste 201
San Antonio, TX 78230
Phone (210) 699-8881

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1487689998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12050 VANCE JACKSON RD",
            "address_2": "BLDG. 2 SUITE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301182",
            "telephone_number": "210-699-8881",
            "fax_number": "210-699-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12050 VANCE JACKSON RD STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301183",
            "telephone_number": "210-699-8881",
            "fax_number": "210-699-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGDAHL JAKOB",
        "first_name": "DIRK",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "11324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIRK",
            "last_name": "MAGDAHL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.