Jaclyn Rose Suchy

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4950 Issued in MN

Practice address

3490 Lexington Ave N Ste 205
Shoreview, MN 55126-8044

Phone

(651) 486-3808

NPI assigned

May 8, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Youth & Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shoreview, MN
  • NPI 1639275852
  Medicare reassignment NPD
• Introspect Mental Health LLC

  • Mental Health Counselor
  • White Bear LK, MN
  • NPI 1184273666
  Medicare reassignment
• Northeast Youth & Family Services

  • Community Health Clinic/Center
  • White Bear Lake, MN
  • NPI 1073098810
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1114717543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 ROBERT DR",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550338807",
            "telephone_number": "651-428-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 LEXINGTON AVE N STE 205",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268044",
            "telephone_number": "651-486-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCHY",
        "first_name": "JACLYN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "4950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita C Stanoch, LP
• Stacey Stark
• Steffen Chiropractic Center, PC
• Stephanie a Johnson
• John Alan Stoltzfus, PH.D.
• Lori Swanson Nebel, CMT
• Peter V. Swenson, D.D.S.
• Michelle Lynn Hovey Swerin, LPCC
• Telephoneme Therapies LLC
• James William Templeton, MSW

• Professional Counselor in Shoreview, MN
• Providers in Shoreview, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.