Active NPI
Caroline Roark
- Professional Counselor
- Fenton, MI
National Provider Identifier
1497526628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 15173 North Rd Ste 100
Fenton, MI 48430-1381 - Phone
- (810) 771-4074
- NPI assigned
- Jan 16, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
15173 North Rd Ste 100
Fenton, MI 48430-1381
Mailing address
15173 North Rd Ste 100
Fenton, MI 48430-1381
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creekside Counseling Group LLC | Professional | Current | Accepting new patients |
Locations
15173 North Rd
Ste 100
Fenton, MI 48430
Phone (810) 208-0879
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705363200000",
"number": "1497526628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15173 NORTH RD STE 100",
"city": "FENTON",
"state": "MI",
"postal_code": "484301381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15173 NORTH RD STE 100",
"city": "FENTON",
"state": "MI",
"postal_code": "484301381",
"telephone_number": "810-771-4074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROARK",
"first_name": "CAROLINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-16",
"last_updated": "2024-01-16",
"certification_date": "2024-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fenton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.