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

Individual provider Clinical Social Worker · NPI 1700687472

Jacob Wyatt, MSW, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Licensed in Minnesota. Registered with an NPI since 2025.

Licensed in
MN
In the registry since
2025
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
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

310 E 38th St Ste 322
Minneapolis, MN 55409-1300
Phone: (612) 824-0415
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 31345 (MN)

Record details

NPI number1700687472
Entity typeIndividual (Type 1)
GenderMale
Credentials MSW , LICSW
Sole proprietorNo
NPI enumeratedMarch 20, 2025
Last updated in NPPESMarch 20, 2025
Certification dateMarch 20, 2025

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