Kaneesha Roarke

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C8016 Issued in OR

Practice address

5455 Almira Dr NE
Bremerton, WA 98311-8330

Phone

(360) 415-5870

NPI assigned

Aug 21, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Mental Health, OR

  Medicare reassignment NPD
• Kitsap Mental Health Services

  • Community/Behavioral Health Agency
  • Bremerton, WA
  • NPI 1033268008
  NPD (past)

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1336796606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 ALMIRA DR NE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983118330",
            "telephone_number": "360-415-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 ALMIRA DR NE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983118330",
            "telephone_number": "360-415-5870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11740 SW 68th Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972239058",
            "country_code": "US",
            "telephone_number": "425-640-7009 x907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROARKE",
        "first_name": "KANEESHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2024-04-24",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C8016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• RMH Services
• Brooklyn F Roach, RBT-23-253806
• Bryan Roach
• Jennifer Inez Roach, BA
• Kaylee Roach
• Chad Robb
• Douglas Burke Robb
• Hallie Robbins
• Robert L. Caulkins, D.O.
• Bethany Roberts

• Mental Health Counselor in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.