Organization
EASTERN SHORE PSYCHOLOGICAL SERVICE
Active
Parent organization
EASTERN SHORE PSYCHOLOGICAL SERVICE
Organization subpart
Yes
Provider details
NPI number
Legal business name
EASTERN SHORE PSYCHOLOGICAL SERVICE
Authorized official
DR. MARY KATHYRN SEIFERT PHD (EXECUTIVE DIRECTOR 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
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259147000
MAGELLAN GROUP
MD
01
—
517251
UHC MAMSI GROUP #
—
05
—
609550001
—
MD
01
—
LM49EA
CAREFIRST BCBS GROUP
MD
01
—
R968
CAREFIRST FEDERAL GROUP
DC
Enumeration date
11/01/2006
Last updated
01/11/2017
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