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
CATHY K BURKHARD (ESPS BILLING SUPERVISOR & CREDENTIA)
(410) 334-6961
Entity
Organization
Contact information
Practice address
315 HIGH ST STE 201, CHESTERTOWN, MD 21620-1350
(410) 334-6961
Mailing address
2336 GODDARD PKWY, SALISBURY, MD 21801-1126
(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
—
609550005
—
MD
Enumeration date
05/24/2016
Last updated
09/20/2016
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