MRS. LISA PETRARCA-GAMIDO LICDC
NPI 1861923807
Counselor - Addiction (Substance Use Disorder) in Stow, OH

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).

Active since March 22, 2017PECOS Enrolled

4161 BRIDGEWATER PKWY, STOW, OH 44224(330) 865-4644(330) 865-4641 Get Directions Write a Review

NPPES record last updated: May 27, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 27, 2025, Nov 10, 2021, Mar 22, 2017 (3 updates tracked since 2017).

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About Mrs. Lisa Petrarca-gamido Licdc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. LISA PETRARCA-GAMIDO LICDC (NPI 1861923807) is an individual addiction (substance use disorder) provider in Stow, Ohio, licensed in Ohio (LICDC.161387) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1861923807

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameMRS. LISA PETRARCA-GAMIDOCredential: LICDC

Location Address4161 BRIDGEWATER PKWYStow, OH 44224-6191

Mailing Address3581 Redwillow WayNorton, OH 44203-4544 · (303) 388-5757

Phone(330) 865-4644

Fax(330) 865-4641

Sole ProprietorYes

Medical School CMSOtherGraduated 2011

Enumeration DateMarch 22, 2017

Last NPPES UpdateMay 27, 20253 updates tracked since enumeration

NPPES CertifiedMay 27, 2025

✔ NPI 1861923807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in OH · LICDC.161387

4161 BRIDGEWATER PKWY, Stow, OH 44224

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include MedMutual, Molina Healthcare, Oscar Insurance Corporation of Ohio.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Lisa Petrarca-gamido Licdc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5991122251

PECOS Enrollment IDI20250710000605

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.