Shanika Rucker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

010394 Issued in CT

Practice address

1000 Lafayette Blvd Ste 1105
Bridgeport, CT 06604-4725

Phone

(203) 296-3345

Fax

(203) 413-5766

NPI assigned

Jun 24, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1396306015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 REMINGTON ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102213",
            "telephone_number": "203-556-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LAFAYETTE BLVD STE 1105",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066044725",
            "telephone_number": "203-296-3345",
            "fax_number": "203-413-5766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Fairfield Ave",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066044252",
            "country_code": "US",
            "telephone_number": "203-394-6529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "SHANIKA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "010394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Joseph Rouse, M.D.
• Robyn Roznitsky
• Marissa Rubin, M.D.
• Jill Rubinstein
• Alexza L Rubio, LCSW
• Reuven Rudich, M.D
• Jason Ruggiero
• Carolann Ruiz
• Marlene Barbara Ruiz
• Eka Rusadze, CRNA

• Clinical Social Worker in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.