Individual provider Active NPI

Trista Jynon Huddleston

  • Professional Counselor
  • Elizabethtown, KY
National Provider Identifier
1114882875
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
303039 Issued in KY
Practice address
308 W Dixie Ave
Elizabethtown, KY 42701-1702
Phone
(270) 234-0003
Fax
(270) 360-0840
NPI assigned
Dec 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 303039 KY Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 286253 KY

Addresses

Primary practice location

308 W Dixie Ave
Elizabethtown, KY 42701-1702

Mailing address

308 W Dixie Ave
Elizabethtown, KY 42701-1702
Phone (270) 234-0003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
286253KYMDAddiction (Substance Use Disorder) Counselor
303039KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Sober Solutions LLC CurrentSince Jan 4, 2026 Accepting new patients

Locations

308 W Dixie Ave
Elizabethtown, KY 42701
Phone (270) 234-0003

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1765843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1114882875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 W DIXIE AVE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011702",
            "telephone_number": "270-234-0003",
            "fax_number": "270-360-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 W DIXIE AVE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011702",
            "telephone_number": "270-234-0003",
            "fax_number": "270-360-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDDLESTON",
        "first_name": "TRISTA",
        "middle_name": "JYNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-16",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "303039",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "286253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.