EASTERN SHORE PSYCHOLOGICAL SERVICE (NPI# 1548348402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548348402 |
| Entity Type | Organization |
| Organization Name | EASTERN SHORE PSYCHOLOGICAL SERVICE |
| Practice Address |
1113 Healthway Drive Salisbury MD 21804 |
| Practice Telephone | 4103346961 |
| Practice Fax Number | 4103346362 |
| Mailing Telephone | 4103346961 |
| Mailing Fax Number | 4103346362 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-01-11 |
| Authorized Official Name | DR. MARY KATHYRN SEIFERT (EXECUTIVE DIRECTOR CEO) |
| Authorized Official Telephone | 4103346961 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | Y |
| Parent Organization Name | EASTERN SHORE PSYCHOLOGICAL SERVICE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | MAGELLAN GROUP | 259147000 | 01 |
| DC | CAREFIRST FEDERAL GROUP | R968 | 01 |
| UHC MAMSI GROUP # | 517251 | 01 | |
| MD | 609550001 | 05 | |
| MD | CAREFIRST BCBS GROUP | LM49EA | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386717189 | Eastern Shore Psychological Service | Community/Behavioral Health | 1113 Healthway Drive, Salisbury, MD 21804 | 2006-11-17 |
| Street Address |
1113 HEALTHWAY DRIVE |
| City | SALISBURY |
| State | MD |
| Zip Code | 21804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093074064 | Eastern Shore Psychological Services, LLC | Counselor | 1113 Healthway Drive, Salisbury, MD 21804 | 2012-05-11 |
| 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 | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1497307318 | B.n.j. Health Services, Inc Salisbury | Clinic/Center | 204 Newton St, Salisbury, MD 21801-5433 | 2019-07-11 |
| 1275027088 | Fearless Growth Therapeutic Services, LLC | Clinic/Center | 225 N Division St Rm 207, Salisbury, MD 21801-4302 | 2018-06-15 |
| 1154320646 | Lower Shore Clinic, Inc. | Clinic/Center | 505 E Main St, Salisbury, MD 21804 | 2005-07-18 |
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| 1356955298 | Peace In Perspective | Clinic/Center | 11 Far Corners Loop, Sparks, MD 21152-9256 | 2020-09-08 |
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| 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.