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

Active since December 29, 2023CLIA 15D2172342 · Waiver
1612 BLACKISTON VIEW DR, CLARKSVILLE, IN 47129(812) 670-4760(812) 725-8702 Get Directions Write a Review

NPPES record last updated: December 29, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Clarksville Psych Hospital, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLARKSVILLE PSYCH HOSPITAL, LLC (NPI 1033988100), doing business as Brightwell Behavioral Health, is a healthcare organization registered as an adult mental health in Clarksville, Indiana and active in the NPI registry since December 2023. The organization holds a CLIA Waiver certificate valid through September 19, 2027 and lists Tamara Moore, Revenue Director, as its authorized official.

NPPES Registry Identity

NPI1033988100
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NameCLARKSVILLE PSYCH HOSPITAL, LLC
Location Address1612 BLACKISTON VIEW DRClarksville, IN 47129-2013
Mailing AddressPo Box 1284Indianapolis, IN 46206-1284 · (812) 670-4760 · Fax (812) 725-8702
Phone(812) 670-4760
Fax(812) 725-8702
Organization SubpartNo
Authorized OfficialTamara MooreRevenue Director · (219) 804-2526
Enumeration DateDecember 29, 2023
NPPES CertifiedDecember 29, 2023
✔ NPI 1033988100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
1612 BLACKISTON VIEW DR, Clarksville, IN 47129
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Other Names 1

Doing Business AsBrightwell Behavioral Health

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2172342

Clarksville Psych Hospital LLC · Clarksville, IN
Active · expires Sep 19, 2027
CLIA Number15D2172342
Laboratory TypeHospital
Certificate Effective DateSeptember 20, 2025
Certificate Expiration DateSeptember 19, 2027
Laboratory DirectorJeremy T. Sullivan
Laboratory Phone(812) 670-4760
Laboratory LocationClarksville Psych Hospital LLC1612 Blackiston View Dr, Clarksville, IN 47129
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CLARKSVILLE PSYCH HOSPITAL, LLC
Psychiatric Hospital
1612 BLACKISTON VIEW DR
CLARKSVILLE, IN 47129
Clark County (317) 870-1396

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clarksville Psych Hospital, LLC's NPI number?

The NPI number for Clarksville Psych Hospital, LLC is 1033988100. It was assigned to this organization in the NPPES registry on December 29, 2023. The provider is doing business as Brightwell Behavioral Health.

Where is Clarksville Psych Hospital, LLC located?

Clarksville Psych Hospital, LLC is located at 1612 Blackiston View Dr, Clarksville, IN 47129. The listed phone number is (812) 670-4760.

What is Clarksville Psych Hospital, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

Does Clarksville Psych Hospital, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2172342) is associated with this NPI, valid through September 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Clarksville Psych Hospital, LLC was last updated on December 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.