Individual provider Active NPI

Audrey Meadows Perry

  • Counselor
  • Massillon, OH
National Provider Identifier
1164053195
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C2002260-TRNE Issued in OH
Practice address
323 Marion Ave NW
Massillon, OH 44646
Phone
(330) 493-3313
Fax
(330) 493-3761
NPI assigned
Jan 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C.2204730 OH
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X C2002260-TRNE OH Primary

Addresses

Primary practice location

323 Marion Ave NW
Massillon, OH 44646

Mailing address

323 Marion Ave NW
Massillon, OH 44646
Phone (330) 493-3313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C.2204730OHMDCounselor
C2002260-TRNEOHMDCounselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1164053195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 MARION AVE NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "44646",
            "telephone_number": "330-493-3313",
            "fax_number": "330-493-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 MARION AVE NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "44646",
            "telephone_number": "330-493-3313",
            "fax_number": "330-493-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "AUDREY",
        "middle_name": "MEADOWS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2024-02-20",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.2204730",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "OH",
            "license": "C2002260-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.