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

Dustin Jacob, LICSW

Individual provider Clinical Social Worker · NPI 1376967570

Dustin Jacob, LICSW is a Clinical Social Worker in Eagan, Minnesota. Graduated from Loyola University of Chicago, Stritch School of Medicine in 2010, 16 years ago. Practices with Eagan Counseling Clinic, a 62-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Illinois and Minnesota.

Years since qualifying
16
Trained at
Loyola University of Chicago, Stritch School of Medicine
Licensed in
IL, MN
In the registry since
2014
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

3450 Oleary Ln
Eagan, MN 55123-2340
Phone: (651) 454-0114
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5346 Lyndale Ave S, Minneapolis, MN 55419-1230 — (612) 746-5888

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 27099 (MN)
Clinical Social Worker Taxonomy 1041C0700X · Licence 149.016078 (IL)

Record details

NPI number1376967570
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedFebruary 7, 2014
Last updated in NPPESApril 23, 2018

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolLOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduated 2010 (16 years in practice)
Group practice Eagan Counseling Clinic — 62 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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