Individual provider Active NPI

Ashlee Alyssa Achtenberg Soberg, MA, BCBA

  • Behavior Analyst
  • Lakeville, MN
National Provider Identifier
1811533573
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA0482 Issued in MN
Practice address
16311 Griffon TRL
Lakeville, MN 55044-7222
Phone
(651) 707-4376
NPI assigned
Nov 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 508-140 WI
Behavior Analyst 103K00000X LBA0482 MN Primary

Addresses

Primary practice location

16311 Griffon TRL
Lakeville, MN 55044-7222

Mailing address

16311 Griffon TRL
Lakeville, MN 55044-7222
Phone (651) 707-4376

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL hrhelp@caravelautism.com

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LBA0482MNMDBehavioral Analyst
508-140WIMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1811533573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16311 GRIFFON TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447222",
            "telephone_number": "651-707-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16311 GRIFFON TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447222",
            "telephone_number": "651-707-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBERG",
        "first_name": "ASHLEE",
        "middle_name": "ALYSSA ACHTENBERG",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "508-140",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MN",
            "license": "LBA0482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "hrhelp@caravelautism.com",
            "affiliation": "N",
            "address_1": "731 Bielenberg Dr Ste 102-105",
            "city": "Woodbury",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551251700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.