Lisa Petrarca-Gamido, LICDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LICDC.161387 Issued in OH

Practice address

4161 Bridgewater Pkwy
Stow, OH 44224-6191

Phone

(330) 865-4644

Fax

(330) 865-4641

NPI assigned

Mar 22, 2017

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

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

Medicare enrollment (NPD)

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.

• Rakesh Ranjan M.D. & Assoc., Inc.

  dba Charak Center for Health and Wellness

  • Clinical Medical Laboratory
  • Garfield Heights, OH
  • NPI 1033143722

  Mental Health

  Medicare reassignment NPD
• Mode - Miracles Occur Days Enriched a Non-Profit Corporation

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fairlawn, OH
  • NPI 1083232102

  Addiction (Substance Use Disorder)

  NPD Authorized official
• Rakesh Ranjan MD & Associates, Inc.

  dba CCHW Pharmacy

  • Specialty Pharmacy
  • Garfield Heights, OH
  • NPI 1225435597
  NPD

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1861923807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3581 REDWILLOW WAY",
            "city": "NORTON",
            "state": "OH",
            "postal_code": "442034544",
            "telephone_number": "303-388-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 BRIDGEWATER PKWY",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442246191",
            "telephone_number": "330-865-4644",
            "fax_number": "330-865-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRARCA-GAMIDO",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• People First Day Program & Transportation
• Carol Janice Pepper
• Wendy Perrin
• Person Centered Therapies, Inc.
• Vincent (None) Petno, M.D.
• Michelle Piper, O.D.
• Amy Pittman, CRC
• Martha K Pitts, LISW
• Duka Devi Pokharel
• Lara Polster

• Addiction (Substance Use Disorder) Counselor in Stow, OH
• Providers in Stow, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.