Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Patrice Alana Jacob, PHD

Individual provider Mental Health Counselor · NPI 1669919148

Dr. Patrice Alana Jacob, PHD is a Mental Health Counselor in Ridgefield, Washington. Qualified in 2015, 11 years ago. Practices as a sole proprietor, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
11
Licensed in
WA
In the registry since
2017
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

1361 S 15th Way
Ridgefield, WA 98642-7826
Phone: (360) 643-9217
Fax: (503) 678-9751
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1104 Main St Ste 550g, Vancouver, WA 98660-2955 — (855) 583-2842

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence MC60704526 (WA)

Record details

NPI number1669919148
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorYes
NPI enumeratedJanuary 23, 2017
Last updated in NPPESJune 4, 2020
Certification dateJune 4, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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