Mandala House, LLC
NPI 1659829760 · Clinical Psychologist · Louisville, KY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mandala House, LLC is a Clinical Psychologist organization in Louisville, KY (NPI 1659829760).
Provider details
- NPI number
- 1659829760
- Entity type
- Organization
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Jacks Gilles, Executive Director(502) 309-2403
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
- Counseling Psychologist103TC1900X
Behavioral Health & Social Service Providers
- Marriage & Family Therapist106H00000X
Behavioral Health & Social Service Providers
- Psychologist103T00000X
Behavioral Health & Social Service Providers
- Psychiatry Physician2084P0800X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
Other names (DBA / former)
- Doing business as
- Mandala House
- Doing business as
- Mandala House
Additional practice locations (2)
- 1190 E BroadwayLouisville, KY 40204-1712Phone: (502) 627-0905Fax: (502) 208-1058
- 1169 Eastern Pkwy Ste 3353Louisville, KY 40217-1415Phone: (502) 309-2408Fax: (502) 771-4283
Registry dates
- Enumerated
- 2016-09-18
- Last updated
- 2026-06-05
- Certified
- 2026-06-05
Frequently asked questions
- What is Mandala House, LLC's NPI number?
- Mandala House, LLC's National Provider Identifier (NPI) is 1659829760, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mandala House, LLC?
- Mandala House, LLC is classified in the NPPES registry as Clinical Psychologist (Behavioral Health & Social Service Providers).
- Where is Mandala House, LLC located?
- Mandala House, LLC's practice location on file with NPPES is 633 Baxter Ave, Louisville, KY 40204-1157.
- What is Mandala House, LLC's phone number?
- The practice phone number listed in the NPPES registry for Mandala House, LLC is (502) 309-2408.
- Does Mandala House, LLC accept Medicare?
- Mandala House, 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 Mandala House, LLC?
- The authorized official listed on Mandala House, LLC's NPPES record is Jacks Gilles, Executive Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mandala House, LLC's NPI active?
- Yes — Mandala House, LLC's NPI (1659829760) is active in the NPPES registry as of the last update on 2026-06-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.