1. Home
  2. Directory
  3. Kentucky
  4. Bowling Green
  5. Nurse Practitioner
  6. NPI Profile
Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

LAKE SUBSTANCE ABUSE SOLUTIONS LLC
NPI 1629900444
Nurse Practitioner - Psychiatric/Mental Health in Bowling Green, KY

Active since June 03, 2026
1143 FAIRWAY ST STE 103, BOWLING GREEN, KY 42103(812) 901-6881(812) 285-8392 Get Directions Write a Review

NPPES record added: June 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lake Substance Abuse Solutions Llc NPPES

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

LAKE SUBSTANCE ABUSE SOLUTIONS LLC (NPI 1629900444) is a healthcare organization registered as a psychiatric/mental health in Bowling Green, Kentucky and active in the NPI registry since June 2026. The organization lists David Corddry, Owner, as its authorized official.

NPPES Registry Identity

NPI1629900444
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameLAKE SUBSTANCE ABUSE SOLUTIONS LLC
Location Address1143 FAIRWAY ST STE 103Bowling Green, KY 42103-2452
Mailing Address1143 Fairway St Ste 103Bowling Green, KY 42103-2452 · (812) 901-6881 · Fax (812) 285-8392
Phone(812) 901-6881
Fax(812) 285-8392
Organization SubpartNo
Authorized OfficialDavid CorddryOwner · (407) 622-8086
Enumeration DateJune 3, 2026
NPPES CertifiedJune 3, 2026
✔ NPI 1629900444 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
1143 FAIRWAY ST STE 103, Bowling Green, KY 42103
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

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

CARMEL J SAUNDERS
Nurse Practitioner (Psychiatric/Mental Health)
1143 FAIRWAY ST STE 103
BOWLING GREEN, KY 42103
Warren County (812) 901-6881
MORGAN DEANN BLEVINS LPCC
Counselor (Mental Health)
1143 FAIRWAY ST STE 103
BOWLING GREEN, KY 42103
Warren County (812) 901-6881
TRANIECE DUNCAN APRN
Nurse Practitioner (Psychiatric/Mental Health)
1143 FAIRWAY ST STE 103
BOWLING GREEN, KY 42103
Warren County (812) 901-6881
PARKER RILEY SMITH PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1143 FAIRWAY ST STE 103
BOWLING GREEN, KY 42103
Warren County (812) 901-6881
CRYSTAL BRAUN LCSW
Social Worker (Clinical)
1143 FAIRWAY ST STE 103
BOWLING GREEN, KY 42103
Warren County (812) 901-6881
ERIC SANTIAGO VELEZ CSW
Social Worker
1143 FAIRWAY ST STE 103
BOWLING GREEN, KY 42103
Warren County (270) 904-6302

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 Substance Abuse Solutions LLC's NPI number?

The NPI number for Lake Substance Abuse Solutions LLC is 1629900444. It was assigned to this organization in the NPPES registry on June 3, 2026.

Where is Lake Substance Abuse Solutions LLC located?

Lake Substance Abuse Solutions LLC is located at 1143 Fairway St Ste 103, Bowling Green, KY 42103. The listed phone number is (812) 901-6881.

What is Lake Substance Abuse Solutions LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Lake Substance Abuse Solutions LLC was last updated on June 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.