Lisa S. Squire, PHD, LP, PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

MNLP0204 Issued in MN

Legal business name

LISA S. SQUIRE, PHD, LP, PA

Practice address

7800 Metro Pkwy
Suite 300
Bloomington, MN 55425-1514

Phone

(952) 854-2440

Fax

(952) 854-2465

NPI assigned

Dec 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Sharon Squire, PHD PSYCHOLOGYNPI 1609872589

Title

Owner

Phone

(952) 854-2440

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Sharon Squire, PH.D., L.P.

  • Clinical Psychologist
  • Bloomington, MN
  • NPI 1609872589
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261094400000",
    "number": "1841529930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 METRO PKWY",
            "address_2": "SUITE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251514",
            "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": "SUITE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251514",
            "telephone_number": "952-854-2440",
            "fax_number": "952-854-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA S. SQUIRE, PHD, LP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-18",
        "last_updated": "2009-12-18",
        "status": "A",
        "authorized_official_last_name": "SQUIRE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "SHARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-854-2440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD PSYCHOLOGY"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "MNLP0204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey M Henke PC
• Richard L Lindstrom, M.D.
• Charles Andrew Lininger, L.AC.
• David Link, MD
• Nicole E Lipinski, PA-C
• Lisa List
• Yuchen Liu, BACHELOR OF SCIENCE
• Livelife Therapy Solutions (Technology for HOME)
• Living Promise, LLC (Promise Care)
• Miah Faye Livingston

• 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 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.