Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenyetta S Douglass

Individual provider Peer Specialist · NPI 1013719152

Kenyetta S Douglass is a Peer Specialist in Canton, Ohio. Licensed in Ohio. Registered with an NPI since 2025.

Licensed in
OH
In the registry since
2025

Practice location Address checks out

131 Wertz Ave NW
Canton, OH 44708-4171
Phone: (234) 214-8470
Fax: (234) 214-8471
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence APS.005628 (OH)

Record details

NPI number1013719152
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 27, 2025
Last updated in NPPESMarch 27, 2025
Certification dateMarch 27, 2025
Mailing address131 Wertz Ave. Nw, Canton, OH 44708-4171

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