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Kenneth Phillip Roach

Counselor

Behavioral Health & Social Service Providers

2215 Langhorne Rd, Lynchburg, VA 24501-1121

PECOS Enrollment

This provider is enrolled in PECOS as KENNETH ROACH.

Based on the most recent information from CMS, provider Kenneth Phillip Roach is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1992389548
Provider Type
Individual
Full Name
Roach, Kenneth Phillip
Title
Mr.
Credential
MA

Gender
Male
Sole Proprietor
No
Enumeration Date
5/10/2021
Last Updated
11/20/2023

Contact Information

Practice Location

2215 Langhorne Rd, Lynchburg, VA 24501-1121

(434) 948-4831

Unlisted Fax

Mailing Location

2215 Langhorne Rd, Lynchburg, VA 24501-1121

(434) 948-4831

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 0701010427 Virginia

Kenneth Phillip Roach

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Beck, Mark W

Outland, Lavanya Monique

Schooler, Karla K

Henderson, Susan Carroll

Cooper, Anne H

Powell, Marianne

Bailey, Ashley

Hine, Jaela

Ehade, Aline Carine Mounto

Burch, Christopher O'Neal