JACALYN LARAE JOHNSON LICSW
NPI 1265024780
Social Worker - Clinical in Rochester, MN

Q: What is Jacalyn Johnson's NPI number?

The NPI number for Jacalyn Johnson is 1265024780. It was assigned to this individual provider in the NPPES registry on February 5, 2021.

Q: What is Jacalyn Johnson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Jacalyn Johnson was last updated on February 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.

Active since February 05, 2021PECOS Enrolled

200 1ST ST SW, ROCHESTER, MN 55905(507) 284-2511 Get Directions Write a Review

NPPES record last updated: February 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 14, 2025, Feb 24, 2021, Feb 5, 2021 (3 updates tracked since 2021).

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About Jacalyn Larae Johnson Licsw NPPES

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

JACALYN LARAE JOHNSON LICSW (NPI 1265024780) is an individual clinical provider in Rochester, Minnesota, licensed in Minnesota (25018) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265024780

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameJACALYN LARAE JOHNSONCredential: LICSW

Location Address200 1ST ST SWRochester, MN 55905-0001

Mailing AddressPo Box 860912, Provider Enrollment - RstMinneapolis, MN 55486-0912 · (507) 284-2511

Phone(507) 284-2511

Sole ProprietorNo

Enumeration DateFebruary 5, 2021

Last NPPES UpdateFebruary 14, 20253 updates tracked since enumeration

NPPES CertifiedFebruary 14, 2025

✔ NPI 1265024780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in MN · 25018

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

200 1ST ST SW, Rochester, MN 55905

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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)

Jacalyn Larae Johnson Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55905 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $56.00 – $168.28

Typical copayment $0.00 (range $14.00 – $42.07)

Most-billed visit code NA

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

EMILY LEASURE MD

Internal Medicine