MRS. KRISTA PUDERBAUGH LPC
NPI 1134501638
Counselor - Professional in Jackson, MS

Q: What is Krista Puderbaugh's NPI number?

The NPI number for Krista Puderbaugh is 1134501638. It was assigned to this individual provider in the NPPES registry on June 22, 2015.

Q: What is Krista Puderbaugh's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Krista Puderbaugh was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 22, 2015

1465 LAKELAND DRIVE, JACKSON, MS 39216(769) 777-1048 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Jul 24, 2017 (3 updates tracked since 2017).

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About Mrs. Krista Puderbaugh Lpc NPPES

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

MRS. KRISTA PUDERBAUGH LPC (NPI 1134501638) is an individual professional provider in Jackson, Mississippi, licensed in Mississippi (2196) and active in the NPI registry since June 2015. She maintains a secondary practice location in Vicksburg.

NPPES Registry Identity

NPI1134501638

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameMRS. KRISTA PUDERBAUGHCredential: LPC

Location Address1465 LAKELAND DRIVEJackson, MS 39216

Mailing Address1465 Lakeland DriveJackson, MS 39216 · (769) 777-1048

Phone(769) 777-1048

Sole ProprietorNo

Enumeration DateJune 22, 2015

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

✔ NPI 1134501638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in MS · 2196

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

1465 LAKELAND DRIVE, Jackson, MS 39216

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Secondary Practice Location 1

Location 13444 Wisconsin AveVicksburg, MS 39180-5331 · Phone (601) 638-0031 ext. 3045

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 Krista Puderbaugh's NPI number?

The NPI number for Krista Puderbaugh is 1134501638. It was assigned to this individual provider in the NPPES registry on June 22, 2015.

Where is Krista Puderbaugh located?

Krista Puderbaugh practices at 1465 Lakeland Drive, Jackson, MS 39216. The listed phone number is (769) 777-1048.

What is Krista Puderbaugh's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Krista Puderbaugh was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.