Individual provider Active NPI

Lakiesha Johnson Squirewell, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Huntersville, NC
National Provider Identifier
1447774823
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5009714 Issued in NC
Practice address
9930 Kincey Ave Ste 100
Huntersville, NC 28078-6541
Phone
(855) 501-1004
NPI assigned
Jul 27, 2017
Last updated
May 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5009714 NC Primary

Addresses

Primary practice location

9930 Kincey Ave Ste 100
Huntersville, NC 28078-6541

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954
Phone (855) 501-1004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171122001330 NC Practitioner - Nurse Practitioner 3375800634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindpath Care Centers North Carolina PLLCGroup PAC ID 4688655517, 115 clinicians

Practice addresses (Care Compare)

6060 Piedmont Row Dr S
Suite 500
Charlotte, NC 28287-3803
Phone (980) 326-3277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5009714NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mindpath Care Centers, North Carolina, PLLC Psychiatric/Mental Health CurrentSince Nov 17, 2019 Accepting new patients

Locations

3835 N Freeway Blvd
Ste 100
Sacramento, CA 95834
Phone (916) 576-7898

4 Doctors Park
Ste H
Asheville, NC 28801
Phone (828) 633-6070

6060 Piedmont Row Dr S
Ste 500
Charlotte, NC 28287
Phone (980) 326-3277

1502 W NC Highway 54
Ste 103
Durham, NC 27707
Phone (919) 354-0840

9930 Kincey Ave
Ste 100
Huntersville, NC 28078
Phone (704) 308-3002

Interoperability endpoints

  • Direct secure messaging: mpsc.lakiesha.squirewell@114018.advancedmd-direct.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1447774823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954",
            "telephone_number": "855-501-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 KINCEY AVE STE 100",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786541",
            "telephone_number": "855-501-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIREWELL",
        "first_name": "LAKIESHA",
        "middle_name": "JOHNSON",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5009714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.