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MRS. HEATHER JOY ROARK PSY D LP NPI 1619048980


NPI Information

NPI: 1619048980
Provider Name: MRS. HEATHER JOY ROARK, PSY D, LP
Classification: Psychologist - 103TC0700X
Entity Type: Individual

Specialization: Clinical

PECOS Registration: Yes

Address:
624 13TH ST S
VIRGINIA, MN
ZIP 55792
Phone: (218) 749-2881
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MRS. Heather Joy Roark, PSY D, LP is a clinical psychologist in Virginia, MN. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. MRS. Heather Joy Roark, PSY D, LP NPI is 1619048980. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

624 13TH ST S
VIRGINIA, MN
ZIP 55792-149
Phone: (218) 749-2881
Fax: (218) 749-3806

The NPI 1619048980 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 11/10/2006 and was last updated on 12/8/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinicalLP5089MINNESOTAYes
2390200000XStudent in an Organized Health Care Education/Training ProgramNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1680002719MEDICARE PINMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.