NPIMap

Organization Active NPI

Eastern Shore Psychological Service

  • Community/Behavioral Health Agency
  • Salisbury, MD
National Provider Identifier
1386717189
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EASTERN SHORE PSYCHOLOGICAL SERVICE
Practice address
1113 Healthway Drive
Salisbury, MD 21804
Phone
(410) 334-6961
Fax
(410) 334-6960
NPI assigned
Nov 17, 2006
Last updated
Jan 11, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
EASTERN SHORE PSYCHOLOGICAL SERVICEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mary Kathyrn Seifert, PHDNPI 1164510178
Title
Executive Director Ceo
Phone
(410) 334-6961

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MD Primary

Addresses

Primary practice location

1113 Healthway Drive
Salisbury, MD 21804

Mailing address

1113 Healthway Drive
Salisbury, MD 21804
Phone (410) 334-6961

Other identifiers 1

IdentifierTypeStateIssuer
609500300MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Eastern Shore Psychological8 organizations share this tax ID, including this one
Part of
Eastern Shore Psychological

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484092800000",
    "number": "1386717189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 HEALTHWAY DRIVE",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "21804",
            "telephone_number": "410-334-6961",
            "fax_number": "410-334-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 HEALTHWAY DRIVE",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "21804",
            "telephone_number": "410-334-6961",
            "fax_number": "410-334-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE PSYCHOLOGICAL SERVICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTERN SHORE PSYCHOLOGICAL SERVICE",
        "enumeration_date": "2006-11-17",
        "last_updated": "2017-01-11",
        "status": "A",
        "authorized_official_last_name": "SEIFERT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KATHYRN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR CEO",
        "authorized_official_telephone_number": "410-334-6961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609500300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.