JACLYN RACHEL JOHNSON MA, LPCC, LADC
NPI 1447912316
Counselor - Professional in Plymouth, MN
About Jaclyn Rachel Johnson Ma, Lpcc, Ladc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACLYN RACHEL JOHNSON MA, LPCC, LADC (NPI 1447912316) is an individual professional provider in Plymouth, Minnesota, licensed in Minnesota (CC04220) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Richfield.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jaclyn Rachel Johnson Ma, Lpcc, Ladc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Jaclyn Johnson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Maple Grove, MN 55369
- Reassigned Medicare billing, Minnesota enrollment
- 44 clinicians in this Medicare group
Richfield, MN 55423
- Reassigned Medicare billing, Minnesota enrollment
- 8 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Johnson's NPI number?
The NPI number for Jaclyn Johnson is 1447912316. It was assigned to this individual provider in the NPPES registry on October 8, 2021.
Where is Jaclyn Johnson located?
Jaclyn Johnson practices at 4100 Berkshire Ln N, Plymouth, MN 55446. The listed phone number is (763) 203-9568.
What is Jaclyn Johnson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Jaclyn Johnson enrolled in Medicare?
Yes. Jaclyn Johnson is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Jaclyn Johnson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jaclyn Johnson reassigns Medicare benefits to 2 organizations: Collaborative Counseling LLC (Maple Grove, MN) and Mending Mental Health (Richfield, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jaclyn Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jaclyn Johnson accept?
Health plans from HealthPartners list Jaclyn Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jaclyn Johnson was last updated on August 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Jaclyn Rachel Johnson, MA, LPCC, LADC · NPI 1447912316
Professional provider in Plymouth, Minnesota. Individual provider, active in the CMS NPPES registry since October 8, 2021.
## Identity
- **NPI:** 1447912316 (Entity type: Individual)
- **Enumerated:** October 8, 2021
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** CC04220 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 4100 BERKSHIRE LN N, Plymouth, MN 55446-3813
- **Phone:** (763) 203-9568
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Collaborative Counseling LLC (NPI 1598034324, Maple Grove, MN); Mending Mental Health (NPI 1720846215, Richfield, MN) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 5, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1447912316) · Data from the CMS NPPES public registry.