Individual provider Active NPI

Dahna Jacobson, LPCC, LADC

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1528829074
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC03247 Issued in MN
Practice address
2120 Park Ave
Minneapolis, MN 55404-3378
Phone
(651) 774-0011
Fax
(651) 774-0606
NPI assigned
Jan 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 303525 MN
Mental Health Counselor 101YM0800X CC03247 MN Primary

Addresses

Primary practice location

2120 Park Ave
Minneapolis, MN 55404-3378

Mailing address

1716 23Rd Ave NE
Minneapolis, MN 55418-3922
Phone (612) 386-8342

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
I20240209002311 MN Practitioner - Mental Health Counselor 1254774979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
People IncorporatedGroup PAC ID 7012043540, 31 clinicians

Practice addresses (Care Compare)

5555 Boone Ave N
New Hope, MN 55428-3669
Phone (651) 774-0011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC03247MNMDMental Health Counselor
3247MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
People Incorporated CurrentSince Feb 12, 2024 Accepting new patients
People Incorporated Current Accepting new patients

Locations

2120 Park Ave
Minneapolis, MN 55404
Phone (612) 872-2000

1930 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 427-7964

5555 Boone Ave N
New Hope, MN 55428
Phone (763) 331-3033

3000 Ames Crossing Rd
Ste 600
Saint Paul, MN 55121
Phone (651) 288-3467

317 York Ave
Saint Paul, MN 55130
Phone (651) 771-0286

Organizations & group practices 2

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": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1528829074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 23RD AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183922",
            "telephone_number": "612-386-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043378",
            "telephone_number": "651-774-0011",
            "fax_number": "651-774-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "DAHNA",
        "credential": "LPCC, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303525",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC03247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.