Family Service Foundation, Inc

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

Legal business name

FAMILY SERVICE FOUNDATION, INC

Practice address

5301 76TH Ave FL 3
Hyattsville, MD 20784-1703

Phone

(301) 459-2121

NPI assigned

May 16, 2006

Last updated

Nov 12, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paula Walker

Title

Ceo

Phone

(301) 459-2121

Specialties & licenses 8

Addresses

Other identifiers 6

Other names 1

• FAMILY SERVICE OF PRINCE GEOGES COUNTY, INC Former legal business name

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Syed Asif H Ali, M.D.

  • Psychiatry Physician
  • Silver Spring, MD
  • NPI 1831284769

  DC

  Medicare reassignment NPD
• Rebecca Louise Deku, LCSW-C

  • Clinical Social Worker
  • Landover Hills, MD
  • NPI 1649618364

  DC

  Medicare reassignment NPD
• Bethanne Louise Moore, M.D.

  • Psychiatry Physician
  • Chevy Chase, MD
  • NPI 1346437472

  DC

  Medicare reassignment NPD
• Leah Campbell

  • Clinical Social Worker
  • Landover Hills, MD
  • NPI 1164067575
  NPD (past)
• Judith Virginia Lelchook, LCSW-C

  • Mental Health Counselor
  • Baltimore, MD
  • NPI 1033428065
  NPD (past)
• Kerri Christina Legette McCullough, ED.D, LPC, LCPC, NCC

  • Counselor
  • Hyattsville, MD
  • NPI 1164871612
  NPD (past)
• Monique Wilson, LCSW, LICSW

  • Clinical Social Worker
  • Silver Spring, MD
  • NPI 1497941819
  NPD (past)
• Valmy Nkienyack Fotendong

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, DC
  • NPI 1730543281
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1700838034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 76TH AVE FL 3",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207841703",
            "telephone_number": "301-459-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 76TH AVE FL 3",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207841703",
            "telephone_number": "301-459-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE FOUNDATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-459-2121"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "MD",
            "license": "5105",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "MD",
            "license": "2427",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266681200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312411800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "589151500",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319111700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320741200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312411801",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY SERVICE OF PRINCE GEOGES COUNTY, INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Rehabilitation Psychologist in Hyattsville, MD
• Providers in Hyattsville, MD by specialty
• Rehabilitation Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.