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Organization
EASTERN SHORE PSYCHOLOGICAL SERVICES LLC
Active
Organization
EASTERN SHORE PSYCHOLOGICAL SERVICES LLC
Active
Parent organization
EASTERN SHORE PSYCHOLOGICAL SERVICES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EASTERN SHORE PSYCHOLOGICAL SERVICES LLC
Authorized official
DR. MARY KATHRYN SEIFERT PHD (EXECUTIVE DIRECTOR CEO)
(410) 334-6961
Entity
Organization
Contact information
Practice address
29520 CANVASBACK DR, EASTON, MD 21601-7124
(410) 822-5007
(410) 822-5569
Mailing address
1113 HEALTHWAY DRIVE, SALISBURY, MD 21804-4470
(410) 334-6961
(410) 334-6362
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386717189
—
MD
05
—
1659630523
—
MD
01
—
259147000
MAGELLAN
MD
01
—
346646
MHN
MD
01
—
517251
UHC MAMSI
—
05
—
520202701
—
MD
05
—
609500301
—
MD
05
—
609550002
—
MD
01
—
LM49EA
BCBS GROUP
MD
01
—
R968
CAREFIRST
—
Enumeration date
10/06/2006
Last updated
08/28/2017
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