LAKE WELLNESS CENTER, LLC
NPI 1164989802
Clinic/Center - Rehabilitation, Substance Use Disorder in New Orleans, LA

Active since March 01, 2019CLIA 19D2166185 · Waiver
3620 CHESTNUT ST, NEW ORLEANS, LA 70115(505) 676-5253(504) 676-5151 Get Directions Write a Review

NPPES record last updated: November 14, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 14, 2025, Mar 1, 2019 (2 updates tracked since 2019).

About Lake Wellness Center, Llc NPPES

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

LAKE WELLNESS CENTER, LLC (NPI 1164989802) is a healthcare organization registered as a rehabilitation, substance use disorder in New Orleans, Louisiana and active in the NPI registry since March 2019. The organization holds a CLIA Waiver certificate valid through May 13, 2027 and lists George Roussel, Owner, as its authorized official.

NPPES Registry Identity

NPI1164989802
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameLAKE WELLNESS CENTER, LLC
Location Address3620 CHESTNUT STNew Orleans, LA 70115-3615
Mailing AddressPo Box 53038Lafayette, LA 70505-3038 · (337) 781-3408
Fax(504) 676-5151
Organization SubpartNo
Authorized OfficialGeorge RousselOwner · (337) 703-0880
Enumeration DateMarch 1, 2019
Last NPPES UpdateNovember 14, 20252 updates tracked since enumeration
NPPES CertifiedNovember 14, 2025
NPI 1164989802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X
3620 CHESTNUT ST, New Orleans, LA 70115

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 19D2166185

Lake Wellness Center Llc-Lafayette · Lafayette, LA
Active · expires May 13, 2027
CLIA Number19D2166185
Laboratory TypePhysician Office
Certificate Effective DateMay 14, 2025
Certificate Expiration DateMay 13, 2027
Laboratory DirectorKelsie M. Graham
Laboratory Phone(337) 800-2626
Laboratory LocationLake Wellness Center Llc-Lafayette200 Heymann Blvd, Suite 201, Lafayette, LA 70505
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

Home Health
3620 CHESTNUT ST
NEW ORLEANS, LA 70115
Marriage & Family Therapist
3620 CHESTNUT ST
NEW ORLEANS, LA 70115
General Practice
3620 CHESTNUT ST
NEW ORLEANS, LA 70115
Physical Medicine & Rehabilitation
3620 CHESTNUT ST
NEW ORLEANS, LA 70115
Home Health
3620 CHESTNUT ST
NEW ORLEANS, LA 70115
Home Health
3620 CHESTNUT ST
NEW ORLEANS, LA 70115
Clinic/Center (Rehabilitation, Substance Use Disorder)
3620 CHESTNUT ST
NEW ORLEANS, LA 70115

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 Lake Wellness Center, LLC's NPI number?

The NPI number for Lake Wellness Center, LLC is 1164989802. It was assigned to this organization in the NPPES registry on March 1, 2019.

Where is Lake Wellness Center, LLC located?

Lake Wellness Center, LLC is located at 3620 Chestnut St, New Orleans, LA 70115. The listed phone number is (505) 676-5253.

What is Lake Wellness Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Does Lake Wellness Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 19D2166185) is associated with this NPI, valid through May 13, 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 Lake Wellness Center, LLC was last updated on November 14, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.