MEDICARE: FAMILY SERVICE FOUNDATION, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	251S00000X	Community/Behavioral Health Agency
4	103TR0400X	Rehabilitation Psychologist	5105	MD
5	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
6	103TR0400X	Rehabilitation Psychologist	2427	MD
7	251B00000X	Case Management Agency
8	103TR0400X	Rehabilitation Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700838034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY SERVICE FOUNDATION, INC

Provider Business Mailing Address
First Line	:	5301 76TH AVE FL 3
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784-1703
Country	:	US
Telephone Number	:	301-459-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	5301 76TH AVE FL 3
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784-1703
Country	:	US
Telephone Number	:	301-459-2121
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	PAULA WALKER
Credential	:
Telephone Number	:	301-459-2121

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	11/12/2025

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Directions to “FAMILY SERVICE FOUNDATION, INC ” Practice Location

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