| Eastern Shore Psychological Services, Llc | |
|
29520 Canvasback Dr Easton MD 21601-7124 | |
| (410) 822-5007 | |
| (410) 822-5569 |
| Full Name | Eastern Shore Psychological Services, Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 29520 Canvasback Dr, Easton, Maryland |
| Authorized Official Name and Position | Mary Kathryn Seifert (EXECUTIVE CEO) |
| Authorized Official Contact | 4103346961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Shore Psychological Services, Llc 2336 Goddard Pkwy Salisbury MD 21801-1126 Ph: (410) 334-6961 | Eastern Shore Psychological Services, Llc 29520 Canvasback Dr Easton MD 21601-7124 Ph: (410) 822-5007 |
| NPI Number | 1659630523 |
|---|---|
| Provider Enumeration Date | 05/11/2012 |
| Last Update Date | 07/31/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659630523 | NPI | - | NPPES |
| R968 | Other | MD | CAREFIRST BCBS-FEDERAL |
| 520202701 | Medicaid | MD | |
| LM49EA | Other | MD | CAREFIRST BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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