DR. LISA SHARON SQUIRE (PH.D., L.P.) – Clinical Psychologist, NPI 1609872589

DR. LISA SHARON SQUIRE (PH.D., L.P.) is a healthcare provider. based in Bloomington, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D., L.P.. They hold a License No. MNLP0204 (MN). The NPI Number for DR. LISA SHARON SQUIRE (PH.D., L.P.) is 1609872589

Main info

Female
Sole Proprietor
43 Years Of Experience
Accepts Medicare Assignment
Name
DR. LISA SHARON SQUIRE (PH.D., L.P.)
NPI
1609872589
Phone
(952) 854-2440
Address
7800 METRO PKWY
Enumeration Date
24 June 2005
Last Update Date
1 December 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9528542440
Graduation Year
1983 (43 years ago)
PAC ID
8729122049
Professional Enrollment ID
I20100224000226
Address ID
MN554251509BL7800XPKWY301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

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Provider Addresses for DR. LISA SHARON SQUIRE (PH.D., L.P.)

  • ReliaCar Transportation, 7800, Metro Parkway, Bloomington, Hennepin County, Minnesota, 55425, United States

    STE 300

    BLOOMINGTON, MN 554251509

    Phone: (952) 854-2440

    Fax: (952) 854-2465

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-02-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100224000226IClinical PsychologistMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55425)

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Reviews

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Frequently asked questions

Can I verify DR. LISA SHARON SQUIRE (PH.D., L.P.) with an NPI only?
You can start verification with NPI 1609872589 for DR. LISA SHARON SQUIRE (PH.D., L.P.), then check state licensing separately.
Does CMS list DR. LISA SHARON SQUIRE (PH.D., L.P.) as active?
Yes — DR. LISA SHARON SQUIRE (PH.D., L.P.) is active in the NPI listing used on this page.
What is DR. LISA SHARON SQUIRE (PH.D., L.P.)'s primary classification?
Clinical Psychologist is the headline specialty for DR. LISA SHARON SQUIRE (PH.D., L.P.) here. Clinical services aligned with this taxonomy classification.
Where should I expect DR. LISA SHARON SQUIRE (PH.D., L.P.) on a map?
Expect Bloomington, Minnesota as a primary anchor for DR. LISA SHARON SQUIRE (PH.D., L.P.) unless the record lists multiple sites.
Why does DR. LISA SHARON SQUIRE (PH.D., L.P.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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