CLARKSVILLE PSYCH HOSPITAL, LLC
NPI 1033988100
Clinic/Center - Adult Mental Health in Clarksville, IN

NPI Status: Active since December 29, 2023

Contact Information

1612 BLACKISTON VIEW DR
CLARKSVILLE, IN
ZIP 47129
Phone: (812) 670-4760
Fax: (812) 725-8702

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  • Organization
  • Clinic/Center
  • Adult Mental Health
  • CLIA Number: 15D2172342
  • CLIA Cert. Type: Hospital
  • CLIA Exp. Date: 09-19-2027

About CLARKSVILLE PSYCH HOSPITAL, LLC

This page provides the complete NPI Profile along with additional information for Clarksville Psych Hospital, Llc, a provider established in Clarksville, Indiana operating as a Clinic/center, focusing in adult mental health . The healthcare provider is registered in the NPI registry with number 1033988100 assigned on December 2023. The practitioner's primary taxonomy code is 261QM0850X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Tamara Moore (Revenue Director)

NPI
1033988100
Provider Name
CLARKSVILLE PSYCH HOSPITAL, LLC
Entity Type
Organization
Location Address
1612 BLACKISTON VIEW DR CLARKSVILLE, IN 47129
Location Phone
(812) 670-4760
Location Fax
(812) 725-8702
Mailing Address
PO BOX 1284 INDIANAPOLIS, IN 46206
Mailing Phone
(812) 670-4760
Mailing Fax
(812) 725-8702
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-29-2023
Last Update Date
12-29-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Adult Mental Health

Taxonomy Code
261QM0850X
Type
Ambulatory Health Care Facilities
Taxonomy Description
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

TAMARA MOORE

Authorized Official Title
REVENUE DIRECTOR
Authorized Official Phone
(219) 804-2526

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
15D2172342
Facility Type
Hospital
Certificate Effective Date
September 20, 2025
Certificate Expiration Date
September 19, 2027
Laboratory Director
JEREMY T. SULLIVAN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Clarksville Psych Hospital, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1033988100, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
3
Doubled → 6
Pos 4
3
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
8
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
1
Unchanged
Pos 9
0
Doubled → 0
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 9 → 18 → 9 8 → 16 → 7 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 6 + 3 + 1 + 8 + 8 + 1 + 6 + 1 + 0 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1033988100.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Psychiatric Hospital
1612 BLACKISTON VIEW DR
CLARKSVILLE, IN 47129

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033988100, enumerated as an "organization" on December 29, 2023.

The provider is located at 1612 BLACKISTON VIEW DR CLARKSVILLE, IN 47129 and the phone number is (812) 670-4760.

Clinic/Center with taxonomy code 261QM0850X and a focus in Adult Mental Health.