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

Michael Jacob

Individual provider Counselor · NPI 1336907575

Michael Jacob is a Mental Health Counselor in Saint Cloud, Minnesota. Qualified in 2021, 5 years ago. Practices with Affinity Psychological Services PC, a 64-clinician group. Licensed in Minnesota.

Years since qualifying
5
Licensed in
MN
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

3400 1st St N Ste 101
Saint Cloud, MN 56303-1924
Phone: (612) 268-5858
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 4331 (MN)
Counselor Taxonomy 101Y00000X · Licence 4331 (MN)

Record details

NPI number1336907575
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 12, 2024
Last updated in NPPESOctober 3, 2024
Certification dateOctober 3, 2024
Mailing address7401 Metro Blvd Ste 250, Edina, MN 55439-3062

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Affinity Psychological Services Pc — 64 clinicians
Accepts Medicare assignment Not indicated

Other providers in Saint Cloud