Gina Petrella, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E-0002433 Issued in OH

Practice address

6140 S Broadway
Lorain, OH 44053-3821

Phone

(440) 204-4100

Fax

(440) 233-4468

NPI assigned

Mar 6, 2007

Last updated

Feb 27, 2024By the provider in NPPES

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riveon Mental Health and RecoveryGroup PAC ID 1557312535, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Riveon Mental Health and Recovery

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lorain, OH
  • NPI 1841268281
  Medicare reassignment Care Compare group NPD
• Riveon Mental Health and Recovery

  • Primary Care Clinic/Center
  • Lorain, OH
  • NPI 1376234914
  NPD
• Riveon Mental Health and Recovery

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lorain, OH
  • NPI 1699034629
  NPD

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1265562904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533891",
            "telephone_number": "440-233-7232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533821",
            "telephone_number": "440-204-4100",
            "fax_number": "440-233-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRELLA",
        "first_name": "GINA",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E-0002433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christopher Petrick
• Chiquitta Petty
• Breyonna Faith Pfeiffer
• Huan Viet Pham, O.D.
• Pharmacy Counter LLC

• Professional Counselor in Lorain, OH
• Providers in Lorain, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.