Provider Demographics
NPI:1164510178
Name:SEIFERT, MARY KATHRYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:KATHRYN
Last Name:SEIFERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2336 GODDARD PARKWAY
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801
Mailing Address - Country:US
Mailing Address - Phone:410-334-6961
Mailing Address - Fax:410-334-6362
Practice Address - Street 1:2336 GODDARD PARKWAY
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801
Practice Address - Country:US
Practice Address - Phone:410-334-6961
Practice Address - Fax:410-334-6362
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03328103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0004OtherCAREFIRST FEDERAL PIN
MD259147000OtherMAGELLAN GROUP
MD54531204OtherCAREFIRST BCBS PIN
MDLM49EAOtherCAREFIRST BCBS GROUP
517251OtherUHC MAMSI GROUP NUMBER
MD522156095OtherOPTIONS HEALTH CARE
MD609550001Medicaid
DCR968OtherCAREFIRST FEDERAL GROUP
MD666Medicare PIN
MD742LMedicare PIN