Healthcare Provider Details

I. General information

NPI: 1922932110
Provider Name (Legal Business Name): ANYA DOIREANN O'CONNOR MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 OLSON MEMORIAL HWY STE 110
GOLDEN VALLEY MN
55422-4811
US

IV. Provider business mailing address

1900 SILVER LAKE RD NW STE 110
NEW BRIGHTON MN
55112-1789
US

V. Phone/Fax

Practice location:
  • Phone: 651-313-8080
  • Fax:
Mailing address:
  • Phone: 651-628-9566
  • Fax: 651-628-0411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5637
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: