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CLEANSE CLINIC JEFFERSONVILLE LLC
NPI 1942728472
Psychiatry & Neurology - Addiction Psychiatry in New Albany, IN

Active since September 05, 2017CLIA 18D2120455 · Certificate of Compliance
1700 STATE ST, NEW ALBANY, IN 47150(812) 914-7038(812) 748-6035 Get Directions Write a Review

NPPES record last updated: January 31, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jul 29, 2023, Jul 18, 2018 (2 updates tracked since 2018).

About Cleanse Clinic Jeffersonville Llc NPPES

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

CLEANSE CLINIC JEFFERSONVILLE LLC (NPI 1942728472) is a healthcare organization registered as an addiction psychiatry in New Albany, Indiana and active in the NPI registry since September 2017. The organization holds a CLIA Certificate of Compliance certificate valid through March 5, 2027 and lists Abdul G Buridi, Ceo, as its authorized official.

NPPES Registry Identity

NPI1942728472
Entity TypeOrganization
Primary Taxonomy2084P0802X
Legal Business NameCLEANSE CLINIC JEFFERSONVILLE LLC
Location Address1700 STATE STNew Albany, IN 47150-4916
Mailing Address720 W Broadway Ste 202Louisville, KY 40202-3245 · (502) 561-0943 · Fax (502) 561-0944
Phone(812) 914-7038
Fax(812) 748-6035
Organization SubpartYesParent: Cleanse Clinic Corporation
Authorized OfficialAbdul G BuridiCeo · (502) 773-5088
Enumeration DateSeptember 5, 2017
Last NPPES UpdateJanuary 31, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 31, 2024
✔ NPI 1942728472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Addiction PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0802X
License✔ Licensed in IN · 1784-0-ASO
Definition
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.
1700 STATE ST, New Albany, IN 47150
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Other Identifiers 1

Medicaid300008912IN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Compliance 18D2120455

Cleanse Clinic Psc · Louisville, KY
Active · expires Mar 5, 2027
CLIA Number18D2120455
Laboratory TypeIndependent
Certificate Effective DateMarch 6, 2025
Certificate Expiration DateMarch 5, 2027
Laboratory DirectorDr. Matthew Rycenga
Laboratory Phone(502) 561-0943
Laboratory LocationCleanse Clinic Psc645 S Roy Wilkins Ave, Louisville, KY 40203
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 2

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

MICHELLE R CURTIS LCAC
Counselor (Addiction (Substance Use Disorder))
1700 STATE ST
NEW ALBANY, IN 47150
Floyd County (812) 914-7038
SARAH ANN THOMAS APRN
Nurse Practitioner (Family)
1700 STATE ST
NEW ALBANY, IN 47150
Floyd County (812) 914-7038

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 Cleanse Clinic Jeffersonville LLC's NPI number?

The NPI number for Cleanse Clinic Jeffersonville LLC is 1942728472. It was assigned to this organization in the NPPES registry on September 5, 2017.

Where is Cleanse Clinic Jeffersonville LLC located?

Cleanse Clinic Jeffersonville LLC is located at 1700 State St, New Albany, IN 47150. The listed phone number is (812) 914-7038.

What is Cleanse Clinic Jeffersonville LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Addiction Psychiatry, with taxonomy code 2084P0802X.

Does Cleanse Clinic Jeffersonville LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 18D2120455) is associated with this NPI, valid through March 5, 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 Cleanse Clinic Jeffersonville LLC was last updated on January 31, 2024. 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.