Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lisa A Peterson, LMHC, LCDPLCDCSMAC

Individual provider Addiction (Substance Use Disorder) Psychologist · NPI 1962514869

Lisa A Peterson, LMHC, LCDPLCDCSMAC is a Mental Health Counselor in Providence, Rhode Island. Qualified in 2002, 24 years ago. Practices with Victa LLC, a 6-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
24
Licensed in
RI
In the registry since
2006
Specialties on file
2
What do these letters mean?
LMHC — Licensed Mental Health Counselor
A licensed mental health counsellor; the title used in Florida, New York and Washington among others.

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Practice location Address checks out

110 Elmwood Ave
Providence, RI 02907-2423
Phone: (401) 432-6029
Fax: (401) 300-5656
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence MHC00235 (RI)
Addiction (Substance Use Disorder) Psychologist Taxonomy 103TA0400X · Licence LCDP00129 (RI)

Record details

NPI number1962514869
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMHC , LCDPLCDCSMAC
Sole proprietorNo
NPI enumeratedAugust 31, 2006
Last updated in NPPESJune 10, 2025
Certification dateJune 10, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Victa Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Providence