Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1679454284 Individual Practitioner Female Practitioner

Amanda Lynn Petersen , CDCA

Peer Specialist • Canton, OH

Professional Overview & Biography Verified Profile Summary

Amanda Petersen, CDCA is a registered healthcare professional specializing in Peer Specialist in Canton, OH. Practice services are available at 624 MARKET AVE N under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

624 Market Ave N

Canton, OH 447021017

Telephone 3302099016
Fax 3304970677
Associated Practice Facility / Clinic
🏢 Trillium Family Solutions Inc Facility NPI 1629034830

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Canton, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 6.5 Yrs
Regional Practice Density
79 Specialists

Practicing in Canton, OH (3139 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-06-22
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

State License OH OCPS.161571

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.

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License OH CDCA.193508

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Debra Casey

Peer Specialist

NPI 1003301482
NPI 1003552464
Laura Elliott-Heckaman , BA

Case Manager/Care Coordinator

NPI 1013420082

Bachelor of Arts

Damonta Mcclendon

Peer Specialist

NPI 1023954211
Mark Woods

Social Worker - Clinical

NPI 1043575400
Deborah Vaughan , LPC

Counselor - Mental Health

NPI 1043840226

Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location June 22, 2026

Registered at 624 MARKET AVE N, CANTON, OH 447021017 (Tel: 3302099016)

📍
Updated Business Mailing Address June 22, 2026

Registered at 624 MARKET AVE N, CANTON, OH 447021017 (Tel: 3302099016)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 22, 2026

Peer Specialist (License #OCPS.161571 in OH)

NPI Profile Active September 10, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location September 10, 2025

Registered at 1711 SPRING AVE NE, CANTON, OH 447142349 (Tel: 3304546800)

📍
Updated Business Mailing Address September 10, 2025

Registered at 625 CLEVELAND AVE NW, CANTON, OH 447021805 (Tel: 3304550374)

👤
Provider Name / Credentials Updated September 10, 2025

Recorded as AMANDA PETERSEN, CDCA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 10, 2025

Counselor (License #CDCA.193508 in OH)

🟢
Initial NPI Registration & Enumeration September 10, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1679454284
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 10, 2025
Last Update: June 22, 2026
Sole Proprietor: No

Mailing Address

624 Market Ave N

Canton, OH 447021017

Phone: 3302099016

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.