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KELLI JEANNE ROARK LICSW, SUDP
NPI 1568722445
Counselor - Mental Health in Arlington, WA

Active since May 24, 2012
4511 188TH ST NE, ARLINGTON, WA 98223(425) 231-7589 Get Directions Write a Review

NPPES record last updated: March 24, 2020. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Kelli Jeanne Roark Licsw, Sudp NPPES

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

KELLI JEANNE ROARK LICSW, SUDP (NPI 1568722445) is an individual mental health provider in Arlington, Washington, licensed in Washington (LW60828872) and active in the NPI registry since May 2012.

NPPES Registry Identity

NPI1568722445
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKELLI JEANNE ROARKCredential: LICSW, SUDP
Location Address4511 188TH ST NEArlington, WA 98223-7778
Mailing Address4511 188th St NeArlington, WA 98223-7778 · (425) 231-7589 · Fax (425) 258-5275
Phone(425) 231-7589
Sole ProprietorNo
Enumeration DateMay 24, 2012
Last NPPES UpdateMarch 24, 2020
NPPES CertifiedMarch 24, 2020
✔ NPI 1568722445 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in WA · LW60828872
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License CP60817555 (WA)
4511 188TH ST NE, Arlington, WA 98223
Open in Google Maps ↗

Other Identifiers 2

OtherCP60817555WA · Substance Use Disorder Professional Certification
OtherLW60828872WA · Social Worker Independent Clinical License

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 Kelli Roark's NPI number?

The NPI number for Kelli Roark is 1568722445. It was assigned to this individual provider in the NPPES registry on May 24, 2012.

Where is Kelli Roark located?

Kelli Roark practices at 4511 188th St NE, Arlington, WA 98223. The listed phone number is (425) 231-7589.

What is Kelli Roark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Kelli Roark was last updated on March 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.