Healthcare Provider Details

I. General information

NPI: 1811809015
Provider Name (Legal Business Name): CAITLIN ANNE RUCKER LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 LEXINGTON CT APT 345
MERRIMACK NH
03054-5709
US

IV. Provider business mailing address

5 LEXINGTON CT APT 345
MERRIMACK NH
03054-5709
US

V. Phone/Fax

Practice location:
  • Phone: 603-459-9933
  • Fax:
Mailing address:
  • Phone: 603-459-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number5850
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: