| Family Service Foundation, Inc | |
|
5301 76th Ave Hyattsville MD 20784-1703 | |
| (301) 459-2121 | |
| (301) 918-9757 |
| Full Name | Family Service Foundation, Inc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 03/08/2024 |
| Certification Date | 03/08/2024 |
| Medicare PECOS PAC ID | 9032131503 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831284769 PECOS PAC ID: 6406897503 Enrollment ID: I20050525001263 |
| Provider Name | Rebecca Louise Deku |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649618364 PECOS PAC ID: 6305086893 Enrollment ID: I20130705000035 |
| Provider Name | Bethanne Moore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346437472 PECOS PAC ID: 0244500312 Enrollment ID: I20210127000005 |
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