Michael Laverdiere, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-20-42370 Issued in MN

Practice address

3721 23Rd St S Apt 201
Saint Cloud, MN 56301-6199

Phone

(218) 457-2185

Fax

(605) 271-3956

NPI assigned

Jul 12, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1710539473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 E 26TH ST STE 1",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571034019",
            "telephone_number": "605-271-2690",
            "fax_number": "605-271-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 23RD ST S APT 201",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563016199",
            "telephone_number": "218-457-2185",
            "fax_number": "605-271-3956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1307 S Lincoln Rd",
            "address_purpose": "LOCATION",
            "city": "Escanaba",
            "state": "MI",
            "postal_code": "498292149",
            "country_code": "US",
            "telephone_number": "906-280-6041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "735 3rd St SW",
            "address_purpose": "LOCATION",
            "city": "Perham",
            "state": "MN",
            "postal_code": "565731152",
            "country_code": "US",
            "telephone_number": "218-214-9950",
            "fax_number": "605-271-3956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 7th Ave S Ste 100",
            "address_purpose": "LOCATION",
            "city": "Escanaba",
            "state": "MI",
            "postal_code": "498291176",
            "country_code": "US",
            "telephone_number": "906-786-6441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVERDIERE",
        "first_name": "MICHAEL",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-12",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "MN",
            "license": "09-19-10548",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": "RBT-18-62994",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MN",
            "license": "1-20-42370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Lau
• Lisa Marie Laubach, L.P.T.
• Grace M Laudenbach
• Janaye Laudenbach, LPCC
• Lori Kay Laudenbach, MA, LPCC, NCC
• Sandra Laverne, PT
• Rachel Lavoi, LICSW
• Kristine Lawrence, P.T.
• Sarah A Layne, DDS
• Keith James Leavell, MD

• Behavior Analyst in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Behavior Analyst in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.