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NPI Code Detail

MEDICARE: DAVID R ROARK LPCC

MEDICARE: DAVID R ROARK LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor104716KY

General Provider Information

NPI Number : 1750431482
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID R ROARK LPCC
Provider Business Mailing Address
First Line : PO BOX 23229
Second Line :
City : OWENSBORO
State : KY
Zip : 42304-3229
Country : US
Telephone Number : 270-688-1330
Fax Number : 270-688-1338
Provider Business Practice Location Address
First Line : 1006 FORD AVE
Second Line :
City : OWENSBORO
State : KY
Zip : 42301-4677
Country : US
Telephone Number : 270-688-4845
Fax Number : 270-688-4811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2007
Last Update Date : 07/18/2025

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Directions to “ DAVID R ROARK LPCC” Practice Location

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