EASTERN SHORE PSYCHOLOGICAL SERVICES, LLC (NPI# 1093074064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093074064 |
| Entity Type | Organization |
| Organization Name | EASTERN SHORE PSYCHOLOGICAL SERVICES, LLC |
| Practice Address |
1113 Healthway Drive Salisbury MD 21804 |
| Practice Telephone | 4103346961 |
| Practice Fax Number | 4103346362 |
| Mailing Telephone | 4103346961 |
| Mailing Fax Number | 4103346362 |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2017-01-11 |
| Authorized Official Name | DR. MARY KATHRYN SEIFERT (EXECUTIVE CEO) |
| Authorized Official Telephone | 4103346961 |
| Authorized Official Credential | PH.D |
| Is Organization Subpart | Y |
| Parent Organization Name | EASTERN SHORE PSYCHOLOGICAL SERVICES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | CAREFIRST BCBS | LM49EA | 01 |
| MD | 520202700 | 05 | |
| MD | CAREFIRST FEDERAL | R968 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356798979 | Eastern Shore Psychological Services, LLC | Clinic/Center | 315 High St Ste 201, Chestertown, MD 21620-1350 | 2016-05-24 |
| 1912356684 | Eastern Shore Psychological Services, LLC | Counselor | 315 High St Ste 201, Chestertown, MD 21620-1350 | 2016-06-03 |
| 1093164766 | Eastern Shore Psychological Services, LLC | Community/Behavioral Health | 315 High St Ste 201, Chestertown, MD 21620-1350 | 2016-06-03 |
| 1821492646 | Eastern Shore Psychological Services, LLC | Community/Behavioral Health | 29520 Canvasback Dr, Easton, MD 21601-7124 | 2014-10-22 |
| 1801155601 | Eastern Shore Psychological Services, LLC | Counselor | 11559 Somerset Ave, Princess Anne, MD 21853-1067 | 2012-05-14 |
| 1659630523 | Eastern Shore Psychological Services, LLC | Counselor | 29520 Canvasback Dr, Easton, MD 21601-7124 | 2012-05-11 |
| 1235226952 | Eastern Shore Psychological Services, LLC | Clinic/Center | 11120 Somerset Ave, Princess Anne, MD 21853-2970 | 2006-10-06 |
| Street Address |
1113 HEALTHWAY DRIVE |
| City | SALISBURY |
| State | MD |
| Zip Code | 21804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548348402 | Eastern Shore Psychological Service | Clinic/Center | 1113 Healthway Drive, Salisbury, MD 21804 | 2006-11-01 |
| 1386717189 | Eastern Shore Psychological Service | Community/Behavioral Health | 1113 Healthway Drive, Salisbury, MD 21804 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578125969 | Lifes Energy Wellness Center Inc. | Community/Behavioral Health | 2324 West Zion Road Suite, Suite 112, Salisbury, MD 21804 | 2019-07-05 |
| 1578125340 | Lifes Energy Wellness Center Inc. | Counselor | 2324 West Zion Road Suite 112, Suite 112, Salisbury, MD 21804 | 2019-07-02 |
| 1093377855 | Lifes Energy Wellness Center Inc. | Clinic/Center | 2324 West Zion Road Suite #112, Salisbury, MD 21804 | 2019-07-02 |
| 1356904874 | Carly Showell Finkbeiner | Behavioral Analyst | 30507 Foxchase Dr, Salisbury, MD 21804 | 2019-04-19 |
| 1750844940 | Clifton Waters | Driver | 206 Davis St, Salisbury, MD 21804 | 2019-04-13 |
| 1487125415 | Rebecca J. Raygor | Social Worker | Wicomico High School, 201 Long Ave., Salisbury, MD 21804 | 2018-12-17 |
| 1639662745 | Peninsula Physical Therapy, LLC | Physical Therapist | 720 E College Ave Ste 11, Salisbury, MD 21804 | 2018-06-13 |
| 1376079533 | Kerry Choplin | Behavior Technician | 8032 Snow Hill Rd., Salisbury, MD 21804 | 2017-05-10 |
| 1558892992 | Three Lower Counties Community Services, Inc. | Clinic/Center | 1647 Woodbrooke Drive, Salisbury, MD 21804 | 2017-03-27 |
| 1508304759 | Driven Physiotherapy, LLC | Clinic/Center | 1029 Zircon Ct., Salisbury, MD 21804 | 2017-02-08 |
| Find all providers in zip 21804 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841803038 | Ellis Butler, Ph.d., LLC | Counselor | 507 W Innes St Ste 270, Salisbury, NC 28144-4265 | 2020-08-26 |
| 1639716103 | Stefanie Danita White | Counselor | 1504 Jake Alexander Blvd W, Salisbury, NC 28147-1213 | 2019-12-04 |
| 1821646324 | Diane Palmer | Counselor | 2324 West Zion Rd., Suit 112, Salisbury, MD 21801 | 2019-08-28 |
| 1578125340 | Lifes Energy Wellness Center Inc. | Counselor | 2324 West Zion Road Suite 112, Suite 112, Salisbury, MD 21804 | 2019-07-02 |
| 1134683238 | Amelia Carmel Hasty-rhodes | Counselor | 303 Saint Johns Dr, Salisbury, NC 28144-9014 | 2019-01-23 |
| 1588142350 | Tabitha Payne | Counselor | 540 Riverside Dr Ste 7, Salisbury, MD 21801-5352 | 2018-08-02 |
| 1881181774 | Aushae Deshields | Counselor | 8182 Brown Rd, Salisbury, MD 21804-2206 | 2018-04-17 |
| 1275038945 | Lisa L Eimer | Counselor | 1980 Earnhardt Rd, Salisbury, NC 28146-2277 | 2018-03-26 |
| 1669970331 | Youth Care Center Incorporated | Counselor | 1504 S Salisbury Blvd Ste 22, Salisbury, MD 21801-7165 | 2018-01-29 |
| 1356875256 | Judith Arnold | Counselor | 130 E Main St Fl 3, Salisbury, MD 21801-5036 | 2017-04-18 |
| Find all providers in SALISBURY | ||||
Please comment or provide details below to improve the information on EASTERN SHORE PSYCHOLOGICAL SERVICES, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.