Tasha Maria Peacock

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

CHW002436 Issued in OH

Practice address

5332 Hollywood Ave
Maple Heights, OH 44137

Phone

(330) 983-7422

NPI assigned

Apr 19, 2024

Last updated

Apr 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1477308773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 VERNON ODOM BLVD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443071867",
            "telephone_number": "330-983-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5332 HOLLYWOOD AVE",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "44137",
            "telephone_number": "330-983-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "TASHA",
        "middle_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": "CHW002436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Patterson
• Kenisha Latoya Patterson, LPN
• Tenecia Marie Patterson
• Mikeyaira Damisha Payton
• Ciara Natasha Peacock
• Tomeka Marie Pemberton
• Perfect Placement Home Care LLC
• Ashley Pettigrew
• Phase One Recovery for Women
• Phase One Recovery House for Women

• Community Health Worker in Maple Heights, OH
• Providers in Maple Heights, OH by specialty
• Community Health Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.