Lake Substance Abuse Solutions LLC
NPI 1124598669ActiveOrganization· Nurse Practitioner, Psych/Mental Health· Jeffersonville, IN
Nurse Practitioner, Psych/Mental Health in Jeffersonville, Indiana, registered in NPPES in November 2018. The authorized official on file is David Corddry, Owner. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1124598669 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 27, 2018 |
| Last updated in NPPES | Sep 2, 2025 |
| Certified by provider | Sep 2, 2025 |
Specialties and licenses
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (IL); Part B Supplier - Clinic/Group Practice (IN); Part B Supplier - Clinic/Group Practice (KY); Part B Supplier - Clinic/Group Practice (TN) |
|---|
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