Larry P Mudd, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003409A Issued in IN

Practice address

1507 Spring Street
Jeffersonvlle, IN 47130-2939

Phone

(407) 347-4536

Fax

(812) 235-2434

NPI assigned

Jul 7, 2005

Last updated

Dec 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

University of Louisville School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lake Substance Abuse Solutions LLCGroup PAC ID 8123440401, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Substance Abuse Solutions LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jeffersonville, IN
  • NPI 1124598669

  KY

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1245237122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SPRING ST",
            "city": "JEFFERSONVLLE",
            "state": "IN",
            "postal_code": "471303554",
            "telephone_number": "812-282-1888",
            "fax_number": "812-218-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 SPRING STREET",
            "city": "JEFFERSONVLLE",
            "state": "IN",
            "postal_code": "471302939",
            "telephone_number": "407-347-4536",
            "fax_number": "812-235-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDD",
        "first_name": "LARRY",
        "middle_name": "P",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "0566",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003409A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2748455000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8200068800",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "800012255",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne Spicer Adams, PA-C
• Gene Allen Baker, PSY.D, HSPP
• Michael Anthony Basso-Williams, D.O.
• Trevor Hollinsworth, OD
• Noell L Rowan, LCSW
• Sydney Elizabeth Sims, PA-C
• Samantha Blain Sisco, NP
• Christopher Ryan Von Kaenel, PA-C
• Jacqueline Anne Williams, OD

• Clinical Social Worker in Jeffersonvlle, IN
• Providers in Jeffersonvlle, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.