Organization
EASTERN SHORE PSYCHOLOGICAL SERVICE, LLC
Active
Parent organization
EASTERN SHORE PSYCHOLOGICAL SERVICE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EASTERN SHORE PSYCHOLOGICAL SERVICE, LLC
Authorized official
DR. MARY KATHYRN SEIFERT PHD (EXECUTIVE DIRECTOR CEO)
(410) 334-6961
Entity
Organization
Contact information
Practice address
11120 SOMERSET AVE, PRINCESS ANNE, MD 21853-2970
(410) 651-4200
(410) 651-4290
Mailing address
2336 GODDARD PARKWAY, SALISBURY, MD 21801
(410) 334-6961
(410) 334-6362
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259147000
MAGELLAN GROUP
MD
01
—
517251
UHC MAMSI GROUP
—
05
—
609500303
—
MD
01
—
LM49EA
CAREFIRST BCBS GROUP
MD
01
—
R968
CAREFIRST FEDERAL GROUP
DC
Enumeration date
11/17/2006
Last updated
08/04/2014
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