Dynasty Maria Rucker

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

PLM1552 Issued in LA

Practice address

11445 Reiger Rd
Baton Rouge, LA 70809-4556

Phone

(225) 932-9867

NPI assigned

Aug 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baton Rouge Treatment Center, LLC

  • Methadone Clinic
  • Baton Rouge, LA
  • NPI 1558401331
  NPD

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1831745678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9222 REDWOOD LAKE BLVD",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707918336",
            "telephone_number": "225-202-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11445 REIGER RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708094556",
            "telephone_number": "225-932-9867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 N I 10 Service Rd W",
            "address_purpose": "LOCATION",
            "city": "Metairie",
            "state": "LA",
            "postal_code": "700066713",
            "country_code": "US",
            "telephone_number": "877-418-2978",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10530 Florida Blvd Apt 319",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708151745",
            "country_code": "US",
            "telephone_number": "225-202-9025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "DYNASTY",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "LA",
            "license": "PLM1552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Methasoft",
            "affiliation": "N",
            "address_1": "11445 Reiger Rd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708094556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Victoria Royal
• Jana Latuso Rozier
• Kyia Rubin
• Leslie Rubio Hernandez
• Carolyn Rucker
• Leah Catherine Rucker, NP
• David Paul Ruckman
• Samantha Marshall Rudd, RN
• Antonia L Ruffin
• Dianne A Ruffin, ET

• Marriage & Family Therapist in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Marriage & Family Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.