# EASTERN SHORE PSYCHOLOGICAL SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EASTERN SHORE PSYCHOLOGICAL SERVICES, LL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1801155601
- **Legal business name:** EASTERN SHORE PSYCHOLOGICAL SERVICES, LL
- **Authorized official:** MARY KATHRYN SEIFERT PH.D. (EXECUTIVE CEO)
- **Authorized official phone:** (410) 334-6961

## Contact information

- **Practice address:** 11559 SOMERSET AVE, PRINCESS ANNE, MD 21853-1067
- **Practice address phone:** (410) 334-6961
- **Practice address fax:** (410) 334-6362
- **Mailing address:** 2336 GODDARD PKWY, SALISBURY, MD 21801-1126
- **Mailing address phone:** (410) 334-6961
- **Mailing address fax:** (410) 334-6362

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 05/14/2012
- **Last updated:** 07/31/2012