Organization
EASTERN SHORE PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KATHRYN SEIFERT PHD (EXECUTIVE 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
2336 GODDARD PKWY, SALISBURY, MD 21801-1126
(410) 334-6961
(410) 334-6362
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
609500300
—
MD
05
—
609500301
—
MD
Enumeration date
10/22/2014
Last updated
03/19/2015
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