Provider Demographics
NPI:1821387556
Name:LADNER, KRISTEN RZOMP (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:RZOMP
Last Name:LADNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21257 W MITCHELL RD
Mailing Address - Street 2:
Mailing Address - City:SAUCIER
Mailing Address - State:MS
Mailing Address - Zip Code:39574-9178
Mailing Address - Country:US
Mailing Address - Phone:228-224-1082
Mailing Address - Fax:228-224-1082
Practice Address - Street 1:21257 W MITCHELL RD
Practice Address - Street 2:
Practice Address - City:SAUCIER
Practice Address - State:MS
Practice Address - Zip Code:39574-9178
Practice Address - Country:US
Practice Address - Phone:228-224-1082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1535101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00018213Medicaid