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NPI Code Detail

MEDICARE: MR. JACOB KIRTS LMHC

MEDICARE: MR. JACOB KIRTS LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor126276IA

General Provider Information

NPI Number : 1467291336
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JACOB KIRTS LMHC
Provider Business Mailing Address
First Line : 1900 SILVER LAKE RD NW STE 110
Second Line :
City : NEW BRIGHTON
State : MN
Zip : 55112-1789
Country : US
Telephone Number : 651-628-9566
Fax Number : 651-628-0411
Provider Business Practice Location Address
First Line : 600 42ND ST
Second Line :
City : DES MOINES
State : IA
Zip : 50312-2701
Country : US
Telephone Number : 515-255-8399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2024
Last Update Date : 06/04/2026

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