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

Mr. Chad Lawrence Jacobs, PMHNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1336783893

Mr. Chad Lawrence Jacobs, PMHNP is a Nurse Practitioner in Mountlake Terrace, Washington. Qualified in 2019, 7 years ago. Practices with Mindful Therapy Group PC, a 646-clinician group and accepts Medicare assignment. Licensed in Florida and Washington.

Years since qualifying
7
Licensed in
FL, WA
In the registry since
2019
Specialties on file
2
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

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Practice location Address checks out

21907 64th Ave W Ste 200
Mountlake Terrace, WA 98043-6200
Phone: (317) 695-8041
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence AP61025855 (WA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 11004760 (FL)

Record details

NPI number1336783893
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP
Sole proprietorNo
NPI enumeratedOctober 29, 2019
Last updated in NPPESNovember 15, 2021
Certification dateNovember 15, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Mindful Therapy Group Pc — 646 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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