Lisa Sharon Squire, PH.D., L.P.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

MNLP0204 Issued in MN

Practice address

7800 Metro Pkwy
Ste 300
Bloomington, MN 55425-1509

Phone

(952) 854-2440

Fax

(952) 854-2465

NPI assigned

Jun 24, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Lisa S. Squire PHD LP Professional name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Lisa S. Squire, PHD, LP, PA

  • Clinical Psychologist
  • Bloomington, MN
  • NPI 1841529930
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1609872589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 METRO PKWY",
            "address_2": "STE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251509",
            "telephone_number": "952-854-2440",
            "fax_number": "952-854-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 METRO PKWY",
            "address_2": "STE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251509",
            "telephone_number": "952-854-2440",
            "fax_number": "952-854-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRE",
        "first_name": "LISA",
        "middle_name": "SHARON",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-24",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "MNLP0204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SQUIRE PHD LP",
            "middle_name": "S.",
            "prefix": "DR.",
            "credential": "PHD LP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Ronald H Spiegel, MD
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• Beth Ann Staab, M.D.
• Stable Services
• Ashley Stabno

• Clinical Psychologist in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.