Kristin Peterson, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

188238 Issued in OH

Practice address

1500 McKinley Ave
Niles, OH 44446-3718

Phone

(330) 953-3300

NPI assigned

May 11, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristin Martin Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1715385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1306694583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5760 PATRIOT BLVD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445151170",
            "telephone_number": "216-699-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MCKINLEY AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444463718",
            "telephone_number": "330-953-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "959 Tod Ave NW Apt A",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444852827",
            "country_code": "US",
            "telephone_number": "216-699-0473",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5760 Patriot Blvd",
            "address_purpose": "LOCATION",
            "city": "Austintown",
            "state": "OH",
            "postal_code": "445151170",
            "country_code": "US",
            "telephone_number": "330-953-0243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KRISTIN",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-11",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "188238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "MARTIN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Druana Perren, PC-CR
• Vanessa Perry
• Michelle A Petak
• Kiaira Peterman
• Rebecca Peters, LPN
• Rachel Petro
• Lexie Pflager
• Hannah Phillips
• Diane Piacquadio
• Bryanna Pickett

• Addiction (Substance Use Disorder) Counselor in Niles, OH
• Providers in Niles, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.