| Eastern Shore Psychological Services, Llc | |
|
11120 Somerset Ave Princess Anne MD 21853-2970 | |
| (410) 651-4200 | |
| (410) 651-4291 |
| Full Name | Eastern Shore Psychological Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| 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 Services, Llc 2336 Goddard Parkway Salisbury MD 21801 Ph: (410) 334-6961 | Eastern Shore Psychological Services, Llc 11120 Somerset Ave Princess Anne MD 21853-2970 Ph: (410) 651-4200 |
| NPI Number | 1235226952 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 08/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235226952 | NPI | - | NPPES |
| 259147000 | Other | MAGELLAN | |
| LM49EA | Other | MD | BCBS GROUP |
| 609550004 | Medicaid | MD | |
| 517251 | Other | UHC MAMSI | |
| R968 | Other | CAREFIRST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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