Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACLYN RACHEL JOHNSON MA, LPCC, LADC
NPI 1447912316
Counselor - Professional in Plymouth, MN

Active since October 08, 2021PECOS Enrolled
4100 BERKSHIRE LN N, PLYMOUTH, MN 55446(763) 203-9568 Get Directions Write a Review

NPPES record last updated: August 5, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 5, 2026, Oct 8, 2021 (2 updates tracked since 2021).

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.

NPPES Registry Identity

NPI1447912316
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJACLYN RACHEL JOHNSONCredential: MA, LPCC, LADC
Location Address4100 BERKSHIRE LN NPlymouth, MN 55446-3813
Mailing Address4100 Berkshire Ln NPlymouth, MN 55446-3813 · (763) 203-9568
Sole ProprietorNo
Enumeration DateOctober 8, 2021
Last NPPES UpdateAugust 5, 20262 updates tracked since enumeration
NPPES CertifiedAugust 5, 2026
NPI 1447912316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in MN · CC04220
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 306063 (MN)
4100 BERKSHIRE LN N, Plymouth, MN 55446

Accepted Insurance

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 Rachel Johnson Ma, Lpcc, Ladc 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.

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.

Counselor (Professional)
4100 BERKSHIRE LN N
PLYMOUTH, MN 55446
Social Worker
4100 BERKSHIRE LN N
PLYMOUTH, MN 55446

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.

What insurance does Jaclyn Johnson accept?

Health plans from HealthPartners and Providence Health Plan 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 15 days 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.