Lake Substance Abuse Solutions LLC
NPI 1124598669 · Psychiatric/Mental Health Nurse Practitioner · Jeffersonville, IN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lake Substance Abuse Solutions LLC is a Psychiatric/Mental Health Nurse Practitioner organization in Jeffersonville, IN (NPI 1124598669).
Provider details
- NPI number
- 1124598669
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- David Corddry, Owner(407) 622-8086
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Psychologist103T00000X
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Nursing Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (2)
- 225 W Canton Ave Ste 600Winter Park, FL 32789-3181Phone: (833) 525-3727
- 1143 Fairway St Unit 110Bowling Green, KY 42103-2452Phone: (833) 525-3727
Registry dates
- Enumerated
- 2018-11-27
- Last updated
- 2025-09-02
- Certified
- 2025-09-02
Frequently asked questions
- What is Lake Substance Abuse Solutions LLC's NPI number?
- Lake Substance Abuse Solutions LLC's National Provider Identifier (NPI) is 1124598669, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Substance Abuse Solutions LLC?
- Lake Substance Abuse Solutions LLC is classified in the NPPES registry as Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Lake Substance Abuse Solutions LLC located?
- Lake Substance Abuse Solutions LLC's practice location on file with NPPES is 1507 Spring St, Jeffersonville, IN 47130-2939.
- What is Lake Substance Abuse Solutions LLC's phone number?
- The practice phone number listed in the NPPES registry for Lake Substance Abuse Solutions LLC is (833) 525-3727.
- Does Lake Substance Abuse Solutions LLC accept Medicare?
- Lake Substance Abuse Solutions LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lake Substance Abuse Solutions LLC?
- The authorized official listed on Lake Substance Abuse Solutions LLC's NPPES record is David Corddry, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Substance Abuse Solutions LLC's NPI active?
- Yes — Lake Substance Abuse Solutions LLC's NPI (1124598669) is active in the NPPES registry as of the last update on 2025-09-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.