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JACLYN ROSE SUCHY
NPI 1114717543
Counselor - Professional in Shoreview, MN

Active since May 08, 2025PECOS Enrolled
3490 LEXINGTON AVE N STE 205, SHOREVIEW, MN 55126(651) 486-3808 Get Directions Write a Review

NPPES record last updated: May 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jaclyn Rose Suchy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACLYN ROSE SUCHY (NPI 1114717543) is an individual professional provider in Shoreview, Minnesota, licensed in Minnesota (4950) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1114717543
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJACLYN ROSE SUCHY
Location Address3490 LEXINGTON AVE N STE 205Shoreview, MN 55126-8044
Mailing Address240 Robert DrHastings, MN 55033-8807 · (651) 428-4423
Phone(651) 486-3808
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMay 8, 2025
NPPES CertifiedMay 8, 2025
✔ NPI 1114717543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MN · 4950
3490 LEXINGTON AVE N STE 205, Shoreview, MN 55126
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaclyn Rose Suchy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3173018462
PECOS Enrollment IDI20251224000275
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JILL MARIE BUCKINGHAM DTR, LICSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
VICKI LYNN SCHROEDER LICSW
Social Worker
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
VANESSA ANN SHUCK MSW, LGSW
Social Worker
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
TRISHA LYNN LORRAINE SARGENT LICSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 379-3414
MISS CARLA KAHALE ANTON LMFT
Marriage & Family Therapist
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
MS. LUCILLE AMIS-ROSARIO MSW, LICSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
MR. STEVEN RICHARD LUTES LICSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 486-3808
SAMANTHA ROSE LUECK MSW, LGSW
Social Worker (Clinical)
3490 LEXINGTON AVE N STE 205
SHOREVIEW, MN 55126
Ramsey County (651) 379-3429

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaclyn Suchy's NPI number?

The NPI number for Jaclyn Suchy is 1114717543. It was assigned to this individual provider in the NPPES registry on May 8, 2025.

Where is Jaclyn Suchy located?

Jaclyn Suchy practices at 3490 Lexington Ave N Ste 205, Shoreview, MN 55126. The listed phone number is (651) 486-3808.

What is Jaclyn Suchy's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Jaclyn Suchy enrolled in Medicare?

Yes. Jaclyn Suchy is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jaclyn Suchy was last updated on May 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.