MEDICARE: TYRENE MAPLE

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1871432286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYRENE MAPLE

Provider Business Mailing Address
First Line	:	2421 HARLEM AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21216-4837
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 NEW YORK AVE NE STE 201
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-1849
Country	:	US
Telephone Number	:	202-506-5187
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2026
Last Update Date	:	03/28/2026

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Directions to “ TYRENE MAPLE ” Practice Location

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