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 PH.D (EXECUTIVE CEO)
(410) 334-6961
Entity
Organization
Contact information
Practice address
1113 HEALTHWAY DRIVE, SALISBURY, MD 21804
(410) 334-6961
(410) 334-6362
Mailing address
1113 HEALTHWAY DRIVE, SALISBURY, MD 21804
(410) 334-6961
(410) 334-6362
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
520202700
—
MD
01
—
LM49EA
CAREFIRST BCBS
MD
01
—
R968
CAREFIRST FEDERAL
MD
Enumeration date
05/11/2012
Last updated
01/11/2017
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