Julie Premo, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301017860 Issued in MI

Practice address

339 Carriage Way
Ypsilanti, MI 48197-7449

Phone

(734) 249-8828

NPI assigned

Mar 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 11, 2024 through Jan 11, 2028

Medicare enrollment (NPD)

Not 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.

• Premo Psychological Services PLLC

  • Adult Mental Health Clinic/Center
  • Ypsilanti, MI
  • NPI 1811710668
  NPD Authorized official

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1881229540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 E EISENHOWER PKWY",
            "address_2": "STE 300 #1166",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083324",
            "telephone_number": "734-249-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 CARRIAGE WAY",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481977449",
            "telephone_number": "734-249-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREMO",
        "first_name": "JULIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-03",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301017860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dexter Tyler Powell, MD
• Lynwood Powell
• Thomas Power, P.A.
• Victoria Ann Powers, MA, LLC
• Premo Psychological Services PLLC
• Erin M Prentice, NP
• Amber Prescott, AGPCNP
• Amy J Preston, CEP
• Cokina Price
• Shakiyla-Ablah Price

• Clinical Psychologist in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.