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KENYETTA S DOUGLASS
NPI 1013719152
Peer Specialist in Canton, OH

Active since March 27, 2025
131 WERTZ AVE NW, CANTON, OH 44708(234) 214-8470(234) 214-8471 Get Directions Write a Review

NPPES record last updated: March 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kenyetta S Douglass NPPES

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

KENYETTA S DOUGLASS (NPI 1013719152) is an individual peer specialist in Canton, Ohio, licensed in Ohio (APS.005628) and active in the NPI registry since March 2025.

NPPES Registry Identity

NPI1013719152
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameKENYETTA S DOUGLASS
Location Address131 WERTZ AVE NWCanton, OH 44708-4171
Mailing Address131 Wertz Ave. NwCanton, OH 44708-4171 · (234) 214-8470 · Fax (234) 214-8471
Phone(234) 214-8470
Fax(234) 214-8471
Sole ProprietorNo
Enumeration DateMarch 27, 2025
NPPES CertifiedMarch 27, 2025
✔ NPI 1013719152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in OH · APS.005628
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
131 WERTZ AVE NW, Canton, OH 44708
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Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. COREY LANE ALTMAN
Peer Specialist
131 WERTZ AVE NW
CANTON, OH 44708
Stark County (234) 214-8470
HAILEY BREANNA HARRIS
Counselor (Addiction (Substance Use Disorder))
131 WERTZ AVE NW
CANTON, OH 44708
Stark County (234) 214-8470
ROBERT BECKETT KEELING
Peer Specialist
131 WERTZ AVE NW
CANTON, OH 44708
Stark County (234) 788-2839
DARNELL STOVALL
Peer Specialist
131 WERTZ AVE NW
CANTON, OH 44708
Stark County (234) 214-8470
LARRY WAYNE ROSS PRS
Peer Specialist
131 WERTZ AVE NW
CANTON, OH 44708
Stark County (234) 214-8470
ENOUGHCS
Counselor (Addiction (Substance Use Disorder))
131 WERTZ AVE NW
CANTON, OH 44708
Stark County (214) 234-8470
PHILLIP CRISLIP
Peer Specialist
131 WERTZ AVE NW
CANTON, OH 44708
Stark County (234) 214-8470
MRS. CAROLYN ANN ABEL CDCA
Counselor (Addiction (Substance Use Disorder))
131 WERTZ AVE NW
CANTON, OH 44708
Stark County (330) 256-8847

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenyetta Douglass's NPI number?

The NPI number for Kenyetta Douglass is 1013719152. It was assigned to this individual provider in the NPPES registry on March 27, 2025.

Where is Kenyetta Douglass located?

Kenyetta Douglass practices at 131 Wertz Ave NW, Canton, OH 44708. The listed phone number is (234) 214-8470.

What is Kenyetta Douglass's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Kenyetta Douglass was last updated on March 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.