Individual provider Active NPI

Matthew Preston Ruckman, LMHC, LCAC

  • Mental Health Counselor
  • Zionsville, IN
National Provider Identifier
1881582666
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39003912A Issued in IN
Practice address
625 N Ford Rd
Zionsville, IN 46077-1245
Phone
(317) 440-7995
NPI assigned
Jun 27, 2025
Last updated
Jun 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 87001689A IN
Mental Health Counselor 101YM0800X 39003912A IN Primary

Addresses

Primary practice location

625 N Ford Rd
Zionsville, IN 46077-1245

Mailing address

625 N Ford Rd
Zionsville, IN 46077-1245
Phone (317) 440-7995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
87001689AINMDAddiction (Substance Use Disorder) Counselor
39003912AINMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ruckman Recovery LLC CurrentSince Aug 3, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1881582666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N FORD RD",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460771245",
            "telephone_number": "317-440-7995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N FORD RD",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460771245",
            "telephone_number": "317-440-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKMAN",
        "first_name": "MATTHEW",
        "middle_name": "PRESTON",
        "credential": "LMHC, LCAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87001689A",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003912A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zionsville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.