Keith Poche, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C010128 Issued in NC

Practice address

608 Jackson St Ste 212
Roanoke Rapids, NC 27870-2600

Phone

(919) 200-5217

Fax

(252) 541-4002

NPI assigned

Dec 5, 2006

Last updated

Nov 3, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, VA, DC3 enrollments

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 3

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arthur Fenner Outreach Center LLCGroup PAC ID 5294105292, 2 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arthur Fenner Outreach Center LLC

  dba Arthur Fenner Outreach Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roanoke Rapids, NC
  • NPI 1144947235
  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  VA

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, DC, NC

  Medicare reassignment NPD
• Southside Behavioral Health

  • Community/Behavioral Health Agency
  • Clarksville, VA
  • NPI 1700890761

  Clinical

  Medicare reassignment NPD
• House of Support Counseling Services, PLLC

  • Clinical Social Worker
  • Roanoke Rapids, NC
  • NPI 1215590112
  Authorized official Same address or phone
• Shauna K Daniels, LCSW

  • Clinical Social Worker
  • Roanoke Rapids, NC
  • NPI 1508205626
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1518025956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 JACKSON ST STE 212",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278702600",
            "telephone_number": "919-200-5217",
            "fax_number": "252-650-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 JACKSON ST STE 212",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278702600",
            "telephone_number": "919-200-5217",
            "fax_number": "252-541-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POCHE",
        "first_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010643",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-22976",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010128",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0718000684",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Louise Perry, RD/LDN
• Diana L Pesteanu, O.D.
• Vanessa Petrillo, BCBA
• Pierces Enterprises LLC
• Laura Thompson Pittman, FNP-BC
• Tina Louise Poindexter, FNP-C
• Marie Lee Pope, LCSW
• Anita Michelle Powell
• Premier Family Health Care Services LLC
• Premier Family Health Care Services LLC

• Clinical Social Worker in Roanoke Rapids, NC
• Providers in Roanoke Rapids, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.