Lisa Premo

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

11 Sycamore St
Worcester, MA 01608-2213

Phone

(508) 798-1900

Fax

(508) 798-1914

NPI assigned

Nov 13, 2019

Last updated

May 18, 2026By the provider in NPPES

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

• Lisa Dube Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Centro Eden Health Care, Inc.

  • PACE Provider Organization
  • Worcester, MA
  • NPI 1356000467
  NPD Authorized official
• Revidas LLC

  dba Revidas

  • Mental Health Counselor
  • Worcester, MA
  • NPI 1528410610
  NPD

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1598300568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SYCAMORE ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016082213",
            "telephone_number": "508-798-1900",
            "fax_number": "508-798-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SYCAMORE ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016082213",
            "telephone_number": "508-798-1900",
            "fax_number": "508-798-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREMO",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "DUBE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Premier Chiropractic Center, LLC
• Premier Family Dental Group, P.C.
• Premier Optical
• Premiere Care LLC
• Premise Health of Massachusetts Medical PC (The Hanover Wellness Center)
• Bridget Prendergast
• Joseph Prendergast, NP
• Vincent James Prendergast, ACNP
• Benjamin D Prentiss, M.D.
• Michelle Katherine Prentiss, M.S.

• Mental Health Counselor in Worcester, MA
• Providers in Worcester, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.