MAPLE SHADE YOUTH AND FAMILY SERVICES, INC. (NPI# 1326376302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326376302 |
| Entity Type | Organization |
| Organization Name | MAPLE SHADE YOUTH AND FAMILY SERVICES, INC. |
| Other Organization Name | PRINCESS ANNE CLINIC |
| Practice Address |
11760 Somerset Ave Princess Anne MD 21853-1239 |
| Practice Telephone | 4106215177 |
| Mailing Telephone | 4106215177 |
| Mailing Fax Number | 4106215051 |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2018-04-30 |
| Authorized Official Name | NIRU JANI (CEO) |
| Authorized Official Telephone | 4107427400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Princess Anne Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942539259 | Maple Shade Youth and Family Services, Inc. | Case Management | 11793 Somerset Ave, Princess Anne, MD 21853-1240 | 2009-12-15 |
| 1780134486 | Maple Shade Youth and Family Services, Inc. | Respite Care | 23704 Ocean Gtwy, Mardela Springs, MD 21837-2101 | 2016-10-06 |
| 1013246271 | Maple Shade Youth and Family Services, Inc. | Case Management | 382 W Main St, Crisfield, MD 21817-1329 | 2009-12-17 |
| 1073841052 | Maple Shade Youth and Family Services, Inc. | Community/Behavioral Health | 382 W Main St, Crisfield, MD 21817-1329 | 2009-12-02 |
| 1104978162 | Maple Shade Youth and Family Services, Inc. | Community/Behavioral Health | 23704 Ocean Gtwy, Mardela Springs, MD 21837-2101 | 2007-01-18 |
| Street Address |
11760 SOMERSET AVE |
| City | PRINCESS ANNE |
| State | MD |
| Zip Code | 21853-1239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417590274 | Destinee Paris Geoghegan | Counselor | 11760 Somerset Ave, Princess Anne, MD 21853-1239 | 2019-10-24 |
| 1306339940 | David Michael Albert | Social Worker | 11760 Somerset Ave, Princess Anne, MD 21853-1239 | 2018-06-08 |
| 1093045304 | Maple Shade Youth & Family Services, Inc. | Case Management | 11760 Somerset Ave, Princess Anne, MD 21853-1239 | 2010-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205478013 | Zachary Castell | Counselor | 30665 Student Services Center Lane, Princess Anne, MD 21853 | 2019-10-14 |
| 1659798759 | Brittany Leigh Heffernan | Dentist | 12165 Elm Street, Princess Anne, MD 21853 | 2014-03-26 |
| 1750670519 | Earl Gene Grantz | Pharmacist | 1251 Brittingham Lane, Rite Aid Pharmacy, Princess Anne, MD 21853 | 2011-04-01 |
| 1356554018 | Somerset County Health Department | Public Health or Welfare | 11674 Somerset Avenue, Princess Anne, MD 21853 | 2007-05-08 |
| 1801008479 | Cedric Rashaw | Counselor | 1 Umes Backbone Road, Princess Anne, MD 21853 | 2007-05-04 |
| 1053408641 | Nancy V Lorsong | Nurse Practitioner | Backbone Rd, Charles Drew Student Health Center, Princess Anne, MD 21853 | 2006-10-06 |
| 1154354744 | Three Lower Counties Community Services, Inc. | Clinic/Center | 12145 Elm Street, Princess Anne, MD 21853 | 2006-07-08 |
| 1750855797 | Rebecca Coryell | Physician Assistant | 12302 Somerset Ave, Suite A, B, Princess Anne, MD 21853 | 2019-01-13 |
| 1205331840 | Kristen Lea Hyland | Dentist | 12165 Elm St, Princess Anne, MD 21853 | 2018-03-26 |
| 1386145118 | Karishma Dilip Patel | Dentist | 12165 Elm St, Princess Anne, MD 21853 | 2018-02-27 |
| Find all providers in zip 21853 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760003347 | Lower Shore Clinic, Inc | Community/Behavioral Health | 11622 Beckford Ave, Princess Anne, MD 21853-1152 | 2020-05-05 |
| 1902432198 | Community Behavioral Health, LLC | Community/Behavioral Health | 30519 Prince William St Apt 1, Princess Anne, MD 21853-1246 | 2020-03-19 |
| 1780127274 | Community Behavioral Health, LLC | Community/Behavioral Health | 30519 Prince William St, Princess Anne, MD 21853-1246 | 2016-12-01 |
| 1588277354 | Go-getters, Inc. | Community/Behavioral Health | 11622 Beckford Ave, Princess Anne, MD 21853-1152 | 2020-08-31 |
| 1568085116 | Community Behavioral Health LLC | Community/Behavioral Health | 30519 Prince William St Apt 1, Princess Anne, MD 21853-1246 | 2020-05-18 |
| 1750816427 | Go-getters, Inc. | Community/Behavioral Health | 11559 Somerset Ave, Princess Anne, MD 21853-1067 | 2017-05-01 |
| 1114461472 | Community Behavioral Health, LLC | Community/Behavioral Health | 30519 Prince William St, Princess Anne, MD 21853-1246 | 2016-12-06 |
| 1104174002 | Go-getters, Inc. | Community/Behavioral Health | 11559 Somerset Ave, Princess Anne, MD 21853-1067 | 2012-08-27 |
| 1033242284 | Three Lower Counties Community Services, Inc. | Community/Behavioral Health | 12145 Elm Street, Princess Anne, MD 21853 | 2007-03-14 |
| 1730252537 | Eastern Shore Psychological Service, LLC | Community/Behavioral Health | 11120 Somerset Ave, Princess Anne, MD 21853-2970 | 2006-11-17 |
| Find all providers in PRINCESS ANNE | ||||
| City | PRINCESS ANNE |
| Zip Code | 21853 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.