Active NPI
Susan Jean Ruckel, MSW, LCSW-C
- Clinical Social Worker
- Street, MD
National Provider Identifier
1992972996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 3116 Tucker Rd
Street, MD 21154-1802 - Phone
- (410) 830-9293
- NPI assigned
- May 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
3116 Tucker Rd
Street, MD 21154-1802
Mailing address
3116 Tucker Rd
Street, MD 21154-1802
Phone (410) 830-9293
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 28, 2025 through Aug 28, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08298 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723161600000",
"number": "1992972996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3116 TUCKER RD",
"city": "STREET",
"state": "MD",
"postal_code": "211541802",
"telephone_number": "410-830-9293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3116 TUCKER RD",
"city": "STREET",
"state": "MD",
"postal_code": "211541802",
"telephone_number": "410-830-9293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUCKEL",
"first_name": "SUSAN",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "MSW, LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-09",
"last_updated": "2024-08-09",
"certification_date": "2024-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Street, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.