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Individual
REBECCA ALEXIS RUCK
Active
Individual
REBECCA ALEXIS RUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, OSW-C
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
0904010145
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023701
AGENCY PROVIDER MEDICAID NUMBER
NJ
01
—
527486
AGENCY PROVIDER MEDICARE #
NJ
Enumeration date
10/29/2010
Last updated
01/20/2022
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