| Eastern Shore Psychological Service, Llc | |
|
11120 Somerset Ave Princess Anne MD 21853-2970 | |
| (410) 651-4200 | |
| (410) 651-4290 |
| Full Name | Eastern Shore Psychological Service, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11120 Somerset Ave, Princess Anne, Maryland |
| Authorized Official Name and Position | Mary Kathyrn Seifert (EXECUTIVE DIRECTOR CEO) |
| Authorized Official Contact | 4103346961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Shore Psychological Service, Llc 2336 Goddard Parkway Salisbury MD 21801 Ph: (410) 334-6961 | Eastern Shore Psychological Service, Llc 11120 Somerset Ave Princess Anne MD 21853-2970 Ph: (410) 651-4200 |
| NPI Number | 1730252537 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 08/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730252537 | NPI | - | NPPES |
| 259147000 | Other | MD | MAGELLAN GROUP |
| 609500303 | Medicaid | MD | |
| R968 | Other | DC | CAREFIRST FEDERAL GROUP |
| LM49EA | Other | MD | CAREFIRST BCBS GROUP |
| 517251 | Other | UHC MAMSI GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Maryland) | Primary |
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