Provider Demographics
NPI:1942624416
Name:RUCKER, MICHAEL HUGH II (LMFT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:HUGH
Last Name:RUCKER
Suffix:II
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SUNCREST TOWN CENTRE DR STE 115
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1873
Mailing Address - Country:US
Mailing Address - Phone:304-282-1975
Mailing Address - Fax:
Practice Address - Street 1:600 SUNCREST TOWN CENTRE DR STE 115
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1873
Practice Address - Country:US
Practice Address - Phone:304-282-1975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2024-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV7106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist