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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

AMANDA LYNN PETERSEN CDCA
NPI 1679454284
Counselor - Addiction (Substance Use Disorder) in Massillon, OH

Active since September 10, 2025
1680 NAVE RD SE, MASSILLON, OH 44646(330) 830-8740(330) 830-0912 Get Directions Write a Review

NPPES record last updated: September 23, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 23, 2026, Aug 17, 2026, Aug 14, 2026 and 1 more (4 updates tracked since 2025).

About Amanda Lynn Petersen Cdca NPPES

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

AMANDA LYNN PETERSEN CDCA (NPI 1679454284) is an individual addiction (substance use disorder) provider in Massillon, Ohio, licensed in Ohio (CDCA.197277) and active in the NPI registry since September 2025. She maintains a secondary practice location in Massillon.

NPPES Registry Identity

NPI1679454284
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameAMANDA LYNN PETERSENCredential: CDCA
Location Address1680 NAVE RD SEMassillon, OH 44646-9604
Mailing Address625 Cleveland Ave NwCanton, OH 44702-1805 · (330) 455-0374 · Fax (330) 453-6716
Phone(330) 830-8740
Fax(330) 830-0912
Sole ProprietorNo
Enumeration DateSeptember 10, 2025
Last NPPES UpdateSeptember 23, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 23, 2026
✔ NPI 1679454284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OH · CDCA.197277
Also ListedPeer SpecialistTaxonomy 175T00000X · License PRS.005719 (OH)
1680 NAVE RD SE, Massillon, OH 44646
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Secondary Practice Location 1

Location 11660 Nave Rd SEMassillon, OH 44646-9604 · Phone (330) 454-6800 · Fax (330) 588-7176

Other Identifiers 1

Medicaid0145225OH

Other Providers at the Same Location NPPES 20

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

KELLY KATHLEEN MCCARTHY LCDCII
Counselor (Addiction (Substance Use Disorder))
1680 NAVE RD SE
MASSILLON, OH 44646
Stark County (330) 830-8740
MRS. JENNIFER S JINKS RN
Registered Nurse
1680 NAVE RD SE
MASSILLON, OH 44646
Stark County (330) 830-8740
PATRICIA ANNE HAYES LPN
Licensed Practical Nurse
1680 NAVE RD SE
MASSILLON, OH 44646
Stark County (330) 830-8740
REBECCA M AJAH MSW, LISW
Social Worker (Clinical)
1680 NAVE RD SE
MASSILLON, OH 44646
Stark County (330) 830-8740
TIFFANY MARIE STEPHAN LPC
Counselor (Mental Health)
1680 NAVE RD SE
MASSILLON, OH 44646
Stark County (330) 830-8740
MATTHEW ROBERT BELL CDCA, PRS
Counselor (Addiction (Substance Use Disorder))
1680 NAVE RD SE
MASSILLON, OH 44646
Stark County (330) 830-8740
SHANIA M ALLEY CDCA
Counselor (Addiction (Substance Use Disorder))
1680 NAVE RD SE
MASSILLON, OH 44646
Stark County (330) 830-8740
OLIVIA L BRITTON CDCA
Counselor (Addiction (Substance Use Disorder))
1680 NAVE RD SE
MASSILLON, OH 44646
Stark County (330) 830-8740

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 Amanda Petersen's NPI number?

The NPI number for Amanda Petersen is 1679454284. It was assigned to this individual provider in the NPPES registry on September 10, 2025.

Where is Amanda Petersen located?

Amanda Petersen practices at 1680 Nave Rd SE, Massillon, OH 44646. The listed phone number is (330) 830-8740.

What is Amanda Petersen's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Amanda Petersen was last updated on September 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days 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.