Cassidy K Rucker, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P2107011 Issued in AR

Practice address

13767 Pella LN
Neosho, MO 64850-8781

Phone

(479) 368-2911

Fax

(479) 391-5254

NPI assigned

Feb 19, 2019

Last updated

Sep 29, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vineyard Counseling LLC

  dba Vineyard Family Counseling

  • Mental Health Counselor
  • Bentonville, AR
  • NPI 1245070762
  NPD

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1861958597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13767 PELLA LN",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648508781",
            "telephone_number": "479-368-2911",
            "fax_number": "479-391-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13767 PELLA LN",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648508781",
            "telephone_number": "479-368-2911",
            "fax_number": "479-391-5254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2703 SE G St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727123740",
            "country_code": "US",
            "telephone_number": "479-368-2911",
            "fax_number": "479-391-5254",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "512 E 32nd St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043903",
            "country_code": "US",
            "telephone_number": "479-368-2911",
            "fax_number": "479-391-5254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "CASSIDY",
        "middle_name": "K",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2107011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Allen Rodriguez, DO
• Rodd Rogers, D.C.
• Kayla M Rose
• Ashton Roush
• Rahab Rubia, OTR
• Makenzie Caprese Sanders, COTA/L
• Angela Marie Santarelli, COTA
• Catherine Schneider, PTA
• Rebekah Schulte
• Ashley Schultz

• Professional Counselor in Neosho, MO
• Providers in Neosho, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.