Individual provider · Type 1 NPI

Lacy Lea Premo

Mental Health Counselor · Gold Beach, OR

NPI number 1023749736 Active

About NPI 1023749736

Lacy Lea Premo's National Provider Identifier is 1023749736, issued on Jun 22, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Gold Beach, OR. The record was last updated on Jun 17, 2025.