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Amanda Lynn Petersen , CDCA

Peer Specialist β€’ Canton, OH

Active NPI 1679454284 Individual Practitioner Female Practitioner
Practice location in NPPES

624 Market Ave N
Canton, OH 447021017

Call 3302099016 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

624 Market Ave N

Canton, OH 447021017

Telephone 3302099016
Fax 3304970677
Organization at the Same NPPES Address or Phone
Trillium Family Solutions Inc Facility NPI 1629034830

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2025

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Canton and Ohio

77 active clinicians are listed under Peer Specialist with a practice address in Canton, OH (3,082 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Canton

0% of these 77 clinicians have the CMS telehealth indicator.

0% of these 77 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-06-22
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

License # reported to NPPES 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

License # reported to NPPES OH CDCA.193508
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

15 listed
Shawn Barnhart-Shuman , LISWS

Social Worker - Clinical

NPI 1861436016
Laura Brison , APRNCNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1649759028

Advanced Practice Registered Nurse - Certified Nurse Practitioner

Judy Chava

Nurse Practitioner - Psychiatric/Mental Health

NPI 1629556949
Dr. Humayun Chughtai , MD

Psychiatry & Neurology - Psychiatry

NPI 1992801088

Doctor of Medicine (M.D.)

Joanne Fritsche

Nurse Practitioner - Psychiatric/Mental Health

NPI 1235416603
Sharon Hoopingarner , CNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1093747784

Certified Nurse Practitioner

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location June 22, 2026

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

πŸ“
Updated Business Mailing Address June 22, 2026

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

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

Peer Specialist (license number reported to NPPES: OH OCPS.161571)

βœ…
NPI Profile Active September 10, 2025

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 10, 2025

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

πŸ“
Business Mailing Address (Initial Record) September 10, 2025

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

πŸ‘€
Provider Name / Credentials (Initial Record) September 10, 2025

Recorded as AMANDA PETERSEN, CDCA

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

Counselor (license number reported to NPPES: OH CDCA.193508)

🟒
Initial NPI Registration & Enumeration September 10, 2025

First registered as active Individual Practitioner in NPPES Database.

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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

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.