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Deactivated NPI 1174851455 Deactivated / Inactive NPI Male Practitioner

Jon Bradley Roark , LPC

Counselor • Columbia, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jon Roark has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 25, 2009
NPI Deactivation Date November 28, 2024
Total Practice Duration ~15 Years of Practice (2009 – 2024)

Professional Overview & Biography Verified Profile Summary

Jon Roark, LPC was a registered Counselor practicing in Columbia, MO. Throughout an active medical career spanning 15 years, Jon Roark provided care at the practice location at 601 BUSINESS LOOP 70 W STE 153A until profile deactivation on 2024-11-28.

Practice Location & Contact Primary Location

Practice Address

601 Business Loop 70 W Ste 153a

Columbia, MO 652032599

Telephone 5734994572
Fax 5732561183
Associated Practice Facility / Clinic
🏢 Morningstar Foundation Facility NPI 1396947230

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Columbia, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.7 Yrs
State Avg: 16.1 Yrs
Regional Practice Density
66 Specialists

Practicing in Columbia, MO (1111 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License MO 2009000984

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Katherine Albers , PLPC

Counselor - Professional

NPI 1043445687
NPI 1114129947

PHDLCSWSW002258

Joy Miller , LPC

Counselor - Mental Health

NPI 1386890119

Licensed Professional Counselor

NPI 1962474379

Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
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NPI Profile Deactivated November 28, 2024

Record deactivated on November 28, 2024

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Updated Practice Location March 05, 2024

Registered at 6833 82ND ST STE 102, LUBBOCK, TX 794245070 (Tel: 8064384510)

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Updated Business Mailing Address March 05, 2024

Registered at 6833 82ND ST STE 102, LUBBOCK, TX 794245070 (Tel: 8064384510)

NPI Profile Active November 10, 2010

NPI status registered as active in NPPES database

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Updated Practice Location November 10, 2010

Registered at 601 BUSINESS LOOP 70 W STE 153A, COLUMBIA, MO 652032599 (Tel: 5734994572)

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Updated Business Mailing Address November 10, 2010

Registered at 601 BUSINESS LOOP 70 W STE 153A, COLUMBIA, MO 652032599 (Tel: 5734994572)

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Provider Name / Credentials Updated November 10, 2010

Recorded as JON ROARK, LPC

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 10, 2010

Counselor (License #2009000984 in MO)

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Initial NPI Registration & Enumeration November 25, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1174851455
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 25, 2009
Last Update: November 10, 2010
Deactivation Date: November 28, 2024

Mailing Address

601 Business Loop 70 W Ste 153a

Columbia, MO 652032599

Phone: 5734994572

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.