DUSTIN JACOB LICSW
NPI 1376967570
Social Worker - Clinical in Eagan, MN

Q: What is Dustin Jacob's NPI number?

The NPI number for Dustin Jacob is 1376967570. It was assigned to this individual provider in the NPPES registry on February 7, 2014.

Q: What is Dustin Jacob's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Dustin Jacob was last updated on April 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 07, 2014PECOS EnrolledAccepts Medicare Assignment

3450 OLEARY LN, EAGAN, MN 55123(651) 454-0114 Get Directions Write a Review

NPPES record last updated: April 23, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dustin Jacob Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DUSTIN JACOB LICSW (NPI 1376967570) is an individual clinical provider in Eagan, Minnesota, licensed in Minnesota (27099) and active in the NPI registry since February 2014. He is enrolled in Medicare PECOS, maintains a secondary practice location in Minneapolis, and is a graduate of Loyola University Of Chicago, Stritch School Of Medicine (2010).

NPPES Registry Identity

NPI1376967570

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameDUSTIN JACOBCredential: LICSW

Location Address3450 OLEARY LNEagan, MN 55123-2340

Mailing Address2523 28th Ave S Apt 2Minneapolis, MN 55406-3194 · (612) 860-6348

Phone(651) 454-0114

Sole ProprietorYes

Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 2010

Enumeration DateFebruary 7, 2014

Last NPPES UpdateApril 23, 2018

✔ NPI 1376967570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

Licenses✔ Licensed in MN · 27099✔ Licensed in IL · 149.016078

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

3450 OLEARY LN, Eagan, MN 55123

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Secondary Practice Location 1

Location 15346 Lyndale Ave SMinneapolis, MN 55419-1230 · Phone (612) 746-5888

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dustin Jacob Licsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2264664267

PECOS Enrollment IDI20180821000748

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55123 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $56.00 – $168.28

Typical copayment $0.00 (range $14.00 – $42.07)

Most-billed visit code NA

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MATTHEW STEVEN CARLSON LPC

Counselor (Professional)