Maple Shade Youth & Family Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MAPLE SHADE YOUTH & FAMILY SERVICES, INC.

Practice address

23704 Ocean Gtwy
Mardela Springs, MD 21837-2101

Phone

(410) 742-7400

NPI assigned

Jan 18, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angela Ford

Title

Clinical Director

Phone

(410) 677-0202

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1104978162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23704 OCEAN GTWY",
            "city": "MARDELA SPRINGS",
            "state": "MD",
            "postal_code": "218372101",
            "telephone_number": "410-742-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23704 OCEAN GTWY",
            "city": "MARDELA SPRINGS",
            "state": "MD",
            "postal_code": "218372101",
            "telephone_number": "410-742-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE SHADE YOUTH & FAMILY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "410-677-0202"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Dawn Holloway-Hill, LCSW-C
• Toni Huffman, LGSW
• Ashley Jester, LMSW
• Julie Johnson, LGSW
• Joseph Raymond Knight, LMSW
• Maple Shade Youth & Family Services, Inc.
• Maple Shade Youth and Family Services, Inc.
• Mardela Springs Volunteer Fire Company Incorporated
• Lamont McKinney
• Tonya O'Hara, LCSW-C

• Community/Behavioral Health Agency in Mardela Springs, MD
• Providers in Mardela Springs, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.