Individual provider · Type 1 NPI

Amanda Lynn Petersen, CDCA

Addiction (Substance Use Disorder) Counselor · Massillon, OH

NPI number 1679454284 Active

Practice location

1680 Nave Rd SE
Massillon, OH 44646-9604

Call (330) 830-8740 Map

Fax (330) 830-0912

Mailing address

625 Cleveland Ave NW
Canton, OH 44702-1805

Other practice locations

  • 1660 Nave Rd SE, Massillon, OH 44646-9604 · (330) 454-6800

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist 175T00000XPRS.005719 (OH)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XCDCA.197277 (OH)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1679454284

Amanda Lynn Petersen, CDCA's National Provider Identifier is 1679454284, issued on Sep 10, 2025. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Massillon, OH. The record was last updated on Sep 23, 2026.