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ROANOKE RESOURCE LLC
NPI 1104170679
Community/Behavioral Health in Roanoke, VA

Active since November 05, 2012CLIA 49D2217511 · Waiver
402 CAMPBELL AVE SW, ROANOKE, VA 24016(540) 400-7431(540) 400-7091 Get Directions Write a Review

NPPES record last updated: January 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 7, 2025, Dec 11, 2019 (2 updates tracked since 2019).

About Roanoke Resource Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROANOKE RESOURCE LLC (NPI 1104170679) is a healthcare organization registered as a community/behavioral health in Roanoke, Virginia and active in the NPI registry since November 2012. The organization holds a CLIA Waiver certificate valid through March 21, 2027 and lists Celia Lea Mccauley-wittl, Operations Coordinator, as its authorized official.

NPPES Registry Identity

NPI1104170679
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameROANOKE RESOURCE LLC
Location Address402 CAMPBELL AVE SWRoanoke, VA 24016-3627
Mailing Address402 Campbell Ave SwRoanoke, VA 24016-3627 · (540) 400-7431 · Fax (540) 400-7091
Phone(540) 400-7431
Fax(540) 400-7091
Organization SubpartNo
Authorized OfficialCelia Lea Mccauley-wittlOperations Coordinator · (540) 400-7431
Enumeration DateNovember 5, 2012
Last NPPES UpdateJanuary 7, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 7, 2025
✔ NPI 1104170679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Also ListedIn Home Supportive CareTaxonomy 253Z00000X
Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
402 CAMPBELL AVE SW, Roanoke, VA 24016
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2217511

Roanoke Resource · Roanoke, VA
Active · expires Mar 21, 2027
CLIA Number49D2217511
Laboratory TypeBehavioral Health
Certificate Effective DateMarch 22, 2025
Certificate Expiration DateMarch 21, 2027
Laboratory DirectorCelia L. Mccauley-Wittl
Laboratory Phone(540) 400-7431
Laboratory LocationRoanoke Resource402 Campbell Ave SW, Roanoke, VA 24016
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GWENDOLYN WILLIAMS SPANGLER NP-C
Nurse Practitioner (Psychiatric/Mental Health)
402 CAMPBELL AVE SW
ROANOKE, VA 24016
Roanoke City (540) 400-7431
ELLEN WEBER
Nurse Practitioner (Psychiatric/Mental Health)
402 CAMPBELL AVE SW
ROANOKE, VA 24016
Roanoke City (540) 400-7431
DR. CELIA LEA MCCAULEY-WITTL DNP, FNP-BC, PMHNP
Nurse Practitioner
402 CAMPBELL AVE SW
ROANOKE, VA 24016
Roanoke City (540) 400-7431
MRS. REBECCA GARST LCSW
Social Worker (Clinical)
402 CAMPBELL AVE SW
ROANOKE, VA 24016
Roanoke City (540) 400-7431
MRS. COURTNI BROOKE SANDRAS-GAUT LCSW
Social Worker (Clinical)
402 CAMPBELL AVE SW
ROANOKE, VA 24016
Roanoke City (540) 400-7431
MIND GARDEN ROANOKE PLLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
402 CAMPBELL AVE SW
ROANOKE, VA 24016
Roanoke City (540) 765-8696

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roanoke Resource LLC's NPI number?

The NPI number for Roanoke Resource LLC is 1104170679. It was assigned to this organization in the NPPES registry on November 5, 2012.

Where is Roanoke Resource LLC located?

Roanoke Resource LLC is located at 402 Campbell Ave SW, Roanoke, VA 24016. The listed phone number is (540) 400-7431.

What is Roanoke Resource LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Does Roanoke Resource LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2217511) is associated with this NPI, valid through March 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Roanoke Resource LLC was last updated on January 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.