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DR. KENNETH DAVID ROACH LCMHC
NPI 1619189628
Counselor - Professional in Salt Lake City, UT

Active since May 03, 2007PECOS EnrolledAccepts Medicare Assignment
4190 S HIGHLAND DR STE 210, SALT LAKE CITY, UT 84124(801) 792-7028 Get Directions Write a Review

NPPES record last updated: October 10, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Kenneth David Roach Lcmhc NPPES

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

DR. KENNETH DAVID ROACH LCMHC (NPI 1619189628) is an individual professional provider in Salt Lake City, Utah, licensed in Utah (4909154-6004) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, maintains a secondary practice location in Pleasant Grove, and is a graduate of University Of Utah School Of Medicine (1999).

NPPES Registry Identity

NPI1619189628
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameDR. KENNETH DAVID ROACHCredential: LCMHC
Location Address4190 S HIGHLAND DR STE 210Salt Lake City, UT 84124-2674
Mailing Address1131 Loch Lomond WaySalt Lake City, UT 84117-4974 · (801) 281-1078 · Fax (801) 269-7565
Phone(801) 792-7028
Sole ProprietorNo
Medical School CMSUniversity Of Utah School Of MedicineGraduated 1999
Enumeration DateMay 3, 2007
Last NPPES UpdateOctober 10, 2018
✔ NPI 1619189628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in UT · 4909154-6004
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 4909154-6004 (UT)
4190 S HIGHLAND DR STE 210, Salt Lake City, UT 84124
Open in Google Maps ↗

Secondary Practice Location 1

Location 1451 E 1000 S Ste BPleasant Grove, UT 84062-3735 · Phone (801) 792-7028

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah, Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kenneth David Roach Lcmhc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456866953
PECOS Enrollment IDI20250714003804
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

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

MIDTOWN COUNSELING
Counselor (Professional)
4190 S HIGHLAND DR STE 210
SALT LAKE CITY, UT 84124
Salt Lake County (801) 792-7028
DR. LISA LYN JONES PH.D.
Psychologist (Counseling)
4190 S HIGHLAND DR STE 210
SALT LAKE CITY, UT 84124
Salt Lake County (385) 399-3696

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 Kenneth Roach's NPI number?

The NPI number for Kenneth Roach is 1619189628. It was assigned to this individual provider in the NPPES registry on May 3, 2007.

Where is Kenneth Roach located?

Kenneth Roach practices at 4190 S Highland Dr Ste 210, Salt Lake City, UT 84124. The listed phone number is (801) 792-7028.

What is Kenneth Roach's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kenneth Roach enrolled in Medicare?

Yes. Kenneth Roach is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kenneth Roach accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and Select Health list Kenneth Roach as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kenneth Roach was last updated on October 10, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.