Provider Demographics
NPI:1992972996
Name:RUCKEL, SUSAN JEAN (MSW, LCSW-C)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JEAN
Last Name:RUCKEL
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3116 TUCKER RD
Mailing Address - Street 2:
Mailing Address - City:STREET
Mailing Address - State:MD
Mailing Address - Zip Code:21154-1802
Mailing Address - Country:US
Mailing Address - Phone:410-830-9293
Mailing Address - Fax:
Practice Address - Street 1:3116 TUCKER RD
Practice Address - Street 2:
Practice Address - City:STREET
Practice Address - State:MD
Practice Address - Zip Code:21154-1802
Practice Address - Country:US
Practice Address - Phone:410-830-9293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty