CLEANSE CLINIC, PLLC
NPI 1659726628
Psychiatry & Neurology - Addiction Psychiatry in Louisville, KY
NPI Status: Active since April 27, 2016
Contact Information
645 S ROY WILKINS AVE STE 100
LOUISVILLE, KY
ZIP 40203
Phone: (502) 583-4092
Fax: (502) 371-6110
- Organization
- Psychiatry & Neurology
- Addiction Psychiatry
- Accepts Insurance
- CLIA Number: 18D2120455
- CLIA Cert. Type: Independent
- CLIA Exp. Date: 03-05-2027
About CLEANSE CLINIC, PLLC
This page provides the complete NPI Profile along with additional information for Cleanse Clinic, Pllc, a provider established in Louisville, Kentucky operating as a Psychiatry & Neurology, focusing in addiction psychiatry . The healthcare provider is registered in the NPI registry with number 1659726628 assigned on April 2016. The practitioner's primary taxonomy code is 2084P0802X with license number 800212 (KY). The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Margaret Groll (Business Manager)
- NPI
- 1659726628
- Provider Name
- CLEANSE CLINIC, PLLC
- Entity Type
- Organization
- Location Address
- 645 S ROY WILKINS AVE STE 100 LOUISVILLE, KY 40203
- Location Phone
- (502) 583-4092
- Location Fax
- (502) 371-6110
- Mailing Address
- 720 W BROADWAY STE 202 LOUISVILLE, KY 40202
- Mailing Phone
- (502) 561-0943
- Mailing Fax
- (502) 371-6110
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-27-2016
- Last Update Date
- 08-13-2024
- Code Navigator
Location Map
Secondary Locations
- 1700 State St
New Albany, IN 47150
(812) 914-7038 - 1616 Harrodsburg Rd
Lexington, KY 40504
(859) 402-8224 - 1800 Highland Ave
Carrollton, KY 41008
(502) 316-6675
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
Psychiatry & Neurology Addiction Psychiatry
- Taxonomy Code
- 2084P0802X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 800212
- License State
- KY
- Taxonomy Description
- Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7100413630 | MEDICAID (05) | KY |
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
- 18D2120455
- Facility Type
- Independent
- Certificate Effective Date
- March 06, 2025
- Certificate Expiration Date
- March 05, 2027
- Laboratory Director
- DR. MATTHEW RYCENGA
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Cleanse Clinic, Pllc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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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 1659726628, we treat the final digit (8) 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
LOUISVILLE, KY 40203
LOUISVILLE, KY 40203
LOUISVILLE, KY 40203
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1659726628, enumerated as an "organization" on April 27, 2016.
The provider is located at 645 S ROY WILKINS AVE STE 100 LOUISVILLE, KY 40203 and the phone number is (502) 583-4092.
Psychiatry & Neurology with taxonomy code 2084P0802X and a focus in Addiction Psychiatry.
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.
