Active NPI
Clarksville Psych Hospital, LLC
- Psychiatric Hospital
- Clarksville, IN
National Provider Identifier
1194373571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- Legal business name
- CLARKSVILLE PSYCH HOSPITAL, LLC
- Practice address
- 1612 Blackiston View Dr
Clarksville, IN 47129 - Phone
- (317) 870-1396
- Fax
- (317) 757-8491
- NPI assigned
- Aug 29, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Morris D Long
- Title
- Coo
- Phone
- (574) 339-3021
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | Primary |
Addresses
Primary practice location
1612 Blackiston View Dr
Clarksville, IN 47129
Mailing address
1612 Blackiston View Dr
Clarksville, IN 47129-2013
Phone (812) 670-4760
Other names 1
- Brightwell Behavioral Health
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191028000049 | IN | Part A Provider - Hospital | 1456683382 | Practice locations: Clarksville, IN |
Hospital certification: CCN 154066
- Legal name
- CLARKSVILLE PSYCH HOSPITAL LLC
- Doing business as
- BRIGHTWELL BEHAVIORAL HEALTH
- Certification status
- Active
- Provider type (POS)
- Hospital – Psychiatric
- Participating since
- Feb 17, 2020
- Last certification
- Feb 17, 2020
- Beds
- 22
- Ownership / control type
- Private (for profit)
- Organization structure
- LLC
- Incorporated
- Aug 24, 2018 in IN
- Enrollment address
- 1612 Blackiston View Dr
Clarksville, IN 47129-2013 - Hospital subgroups
- Psychiatric
Care Compare: Hospital
Medicare Care Compare- Listed as
- Brightwell Behavioral Health
- Type
- Psychiatric
- Ownership
- Proprietary
- Medicare certification status
- Active
- Emergency services
- No
National Provider Directory
National Provider Directory- Tax ID family
- Clarksville Psych Hospital LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Mental Health Clinic/Center
- Clarksville, IN
- NPI 1033988100
Ownership & related parties
All disclosed owners & managing parties 3
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Christopher King | Corporate Officer | Aug 24, 2018 | 50% |
| Operational/Managerial Control | Jun 1, 2023 | 50% | |
| Clarksville Psych JV, LLC | 5% Or Greater Direct Ownership Interest | Aug 29, 2018 | 100% |
| Tamara a Moore | Corporate Director | May 29, 2023 | 10% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567036800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788307200000",
"number": "1194373571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1612 BLACKISTON VIEW DR",
"city": "CLARKSVILLE",
"state": "IN",
"postal_code": "471292013",
"telephone_number": "812-670-4760",
"fax_number": "812-954-0851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1612 BLACKISTON VIEW DR",
"city": "CLARKSVILLE",
"state": "IN",
"postal_code": "47129",
"telephone_number": "317-870-1396",
"fax_number": "317-757-8491"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLARKSVILLE PSYCH HOSPITAL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-08-29",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A",
"authorized_official_last_name": "LONG",
"authorized_official_first_name": "MORRIS",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "574-339-3021"
},
"taxonomies": [
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Brightwell Behavioral Health",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Clarksville, IN
- Clarksville Community School Corporation
- Clarksville Dental Care, LLC
- Clarksville MRI
- Clarksville Primary Care, LLC
- Clarksville Psych Hospital, LLC
- Clarksville Rehabilitation Hospital LLC
- Clarksville Spine and Rehabilitation
- Clean Health Medical, LLC
- Cobalt Rehabilitation Hospital Louisville LLC
- Roberta Elaine Coleman, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.