Roark, Kelli Jeanne

Roark, Kelli Jeanne is an individual health care provider with primary practice located at 4511 188Th St Ne , Arlington WA 98223-7778. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Roark, Kelli Jeanne can be contacted via phone (425) 231-7589.

Contact Information

Primary practice address
4511 188Th St Ne Arlington WA 98223-7778
Phone: (425) 231-7589
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CP60817555 Washington
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LW60828872 Washington

Profile Details

NPI number 1568722445
LBN Legal business name Roark, Kelli Jeanne
Credentials LICSW, SUDP
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2012
Last updated Mar 24th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568722445 NPPES
Washington Other LW60828872 SOCIAL WORKER INDEPENDENT CLINICAL LICENSE
Washington Other CP60817555 SOCIAL WORKER INDEPENDENT CLINICAL LICENSE

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