Individual provider Active NPI

Lauren Ireland O'Dougherty, BCBA

  • Behavior Analyst
  • Minneapolis, MN
National Provider Identifier
1700547106
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA0840 Issued in MN
Practice address
5010 Cheshire Pkwy N
Minneapolis, MN 55446-4102
Phone
(612) 445-8314
NPI assigned
Jan 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X LBA0840 MN Primary

Addresses

Primary practice location

5010 Cheshire Pkwy N
Minneapolis, MN 55446-4102

Mailing address

717 4TH St NE Unit 1
Minneapolis, MN 55413-2018
Phone (651) 895-3967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LBA0840MNMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1700547106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 4TH ST NE UNIT 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132018",
            "telephone_number": "651-895-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 CHESHIRE PKWY N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554464102",
            "telephone_number": "612-445-8314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DOUGHERTY",
        "first_name": "LAUREN",
        "middle_name": "IRELAND",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MN",
            "license": "LBA0840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.