SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER INC.
NPI 1972092047
Clinic/Center - Rehabilitation, Substance Use Disorder in East Chicago, IN
About Southlake Community Mental Health Center Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHLAKE COMMUNITY MENTAL HEALTH CENTER INC. (NPI 1972092047) is a healthcare organization registered as a rehabilitation, substance use disorder in East Chicago, Indiana and active in the NPI registry since May 2018. The organization lists Shirley A Roll, Enrollment, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southlake Community Mental Health Center Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
74Medicare enrollment records show 74 clinicians reassign Medicare billing to Southlake Community Mental Health Center Inc., which bills Medicare for the services they deliver. Of these, 7 practice at this address and 18 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 11
Nearest to this location (20)
See all 74Chicago, IL 60617
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Southlake Community Mental Health Center Inc.'s NPI number?
The NPI number for Southlake Community Mental Health Center Inc. is 1972092047. It was assigned to this organization in the NPPES registry on May 4, 2018.
Where is Southlake Community Mental Health Center Inc. located?
Southlake Community Mental Health Center Inc. is located at 3903 Indianapolis Blvd, East Chicago, IN 46312. The listed phone number is (219) 398-7050.
What is Southlake Community Mental Health Center Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.
Is Southlake Community Mental Health Center Inc. enrolled in Medicare?
Yes. Southlake Community Mental Health Center Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southlake Community Mental Health Center Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 74 clinicians in 11 Medicare specialties reassign their Medicare billing to Southlake Community Mental Health Center Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (18), Psychiatry (14) and Mental Health Counselor (12). Of these, 7 practice at this address and 18 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Southlake Community Mental Health Center Inc. accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Southlake Community Mental Health Center Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southlake Community Mental Health Center Inc. was last updated on June 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Southlake Community Mental Health Center Inc. · NPI 1972092047
Rehabilitation, Substance Use Disorder organization in East Chicago, Indiana. Organization record, active in the CMS NPPES registry since May 4, 2018.
## Identity
- **NPI:** 1972092047 (Entity type: Organization)
- **Enumerated:** May 4, 2018
- **Primary specialty:** Clinic/Center - Rehabilitation, Substance Use Disorder · taxonomy 261QR0405X
- **Organization subpart:** No
- **Authorized official:** Shirley Roll, ENROLLMENT
## Practice location
- **Address:** 3903 INDIANAPOLIS BLVD, East Chicago, IN 46312
- **Phone:** (219) 398-7050 · **Fax:** (219) 392-3998
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 74 clinicians in 11 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (18), Psychiatry (14), Mental Health Counselor (12); 7 practice at this address and 18 within 10 miles; [full list](https://npiprofile.com/npi/1972092047/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 12, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1972092047) · Data from the CMS NPPES public registry.