Provider Demographics
NPI:1720894884
Name:ROARK, LINDSEY (CAS)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:ROARK
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 ACOMA ST UNIT 401
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4042
Mailing Address - Country:US
Mailing Address - Phone:310-988-8028
Mailing Address - Fax:
Practice Address - Street 1:9725 E HAMPDEN AVE # G130
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4915
Practice Address - Country:US
Practice Address - Phone:310-988-8028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC.0021309101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)