Family Service Foundation, Inc | |
5301 76th Ave Hyattsville MD 20784-1703 | |
(301) 459-2121 | |
(301) 918-9757 |
Full Name | Family Service Foundation, Inc |
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Speciality | Psychologist |
Location | 5301 76th Ave, Hyattsville, Maryland |
Authorized Official Name and Position | Daphne Smith (BILLING MANAGER) |
Authorized Official Contact | 3014592121 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Service Foundation, Inc 5301 76th Ave Hyattsville MD 20784-1703 Ph: (301) 459-2121 | Family Service Foundation, Inc 5301 76th Ave Hyattsville MD 20784-1703 Ph: (301) 459-2121 |
NPI Number | 1700838034 |
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Provider Enumeration Date | 05/16/2006 |
Last Update Date | 03/08/2024 |
Certification Date | 03/08/2024 |
Medicare PECOS PAC ID | 9032131503 |
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Medicare Enrollment ID | O20051227000477 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700838034 | NPI | - | NPPES |
266681200 | Medicaid | MD | |
312411800 | Medicaid | MD | |
312411801 | Medicaid | MD | |
320741200 | Medicaid | MD | |
319111700 | Medicaid | MD | |
589151500 | Medicaid | MD |
Provider Name | Syed Asif H Ali |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1831284769 PECOS PAC ID: 6406897503 Enrollment ID: I20050525001263 |
Provider Name | Rebecca Louise Deku |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1649618364 PECOS PAC ID: 6305086893 Enrollment ID: I20130705000035 |
Provider Name | Bethanne Moore |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1346437472 PECOS PAC ID: 0244500312 Enrollment ID: I20210127000005 |
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