Active NPI
Judith Roark, LCPC
- Professional Counselor
- West Friendship, MD
National Provider Identifier
1902207400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC1072
- Practice address
- 2675 Pfefferkorn Rd
West Friendship, MD 21794-9417 - Phone
- (301) 854-6797
- NPI assigned
- Sep 16, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | LC1072 | MD | Primary |
Addresses
Primary practice location
2675 Pfefferkorn Rd
West Friendship, MD 21794-9417
Mailing address
2675 Pfefferkorn Rd
West Friendship, MD 21794-9417
Phone (301) 854-6797
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC1072 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410825600000",
"number": "1902207400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2675 PFEFFERKORN RD",
"city": "WEST FRIENDSHIP",
"state": "MD",
"postal_code": "217949417",
"telephone_number": "301-854-6797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2675 PFEFFERKORN RD",
"city": "WEST FRIENDSHIP",
"state": "MD",
"postal_code": "217949417",
"telephone_number": "301-854-6797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROARK",
"first_name": "JUDITH",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-16",
"last_updated": "2014-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC1072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Friendship, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.