MRS. KRISTA PUDERBAUGH LPC NPI 1134501638

NPI Information

  • NPI: 1134501638
  • Provider Name: MRS. KRISTA PUDERBAUGH, LPC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 1465 LAKELAND DRIVE
    JACKSON, MS
    ZIP 39216
  • Phone: (769) 777-1048

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NPI Details

MRS. Krista Puderbaugh, LPC is a professional counselor in Jackson, MS. MRS. Krista Puderbaugh, LPC NPI is 1134501638. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1465 LAKELAND DRIVE
JACKSON, MS
ZIP 39216
Phone: (769) 777-1048

The enumeration date for this NPI number is 6/22/2015 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2101YP2500XCounselorProfessional2196MISSISSIPPIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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