Kristi Gowell Roark, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1355 Issued in NH

Practice address

10 Endicot Street
Wolfeboro, NH 03894

Phone

(603) 569-4776

NPI assigned

Apr 3, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northern Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Center Conway, NH
  • NPI 1700955028
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1174644215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255",
            "city": "WOLFEBORO",
            "state": "NH",
            "postal_code": "038940255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ENDICOT STREET",
            "city": "WOLFEBORO",
            "state": "NH",
            "postal_code": "03894",
            "telephone_number": "603-569-4776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Bay St",
            "address_purpose": "LOCATION",
            "city": "Wolfeboro",
            "state": "NH",
            "postal_code": "038944320",
            "country_code": "US",
            "telephone_number": "603-569-1884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROARK",
        "first_name": "KRISTI",
        "middle_name": "GOWELL",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "7706638Y0NH01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Richards
• Brent Richardson
• Margaret Rieser
• Rite Aid Corp
• Shayna Colleen Rivard, MD
• Robert I Williams Hearing AIDS LLC
• Thomas W Rock, MD
• Bethany Roun, ATC
• Paul Ruiz, NRP
• Oana Rujan, RPH

• Clinical Social Worker in Wolfeboro, NH
• Providers in Wolfeboro, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.