Healthcare Provider Details

I. General information

NPI: 1043166333
Provider Name (Legal Business Name): TALBOT PSYCHOLOGY ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6547 PEACH BLOSSOM HEIGHTS DR
EASTON MD
21601-4517
US

IV. Provider business mailing address

8168 ELLIOTT RD STE 1
EASTON MD
21601-7111
US

V. Phone/Fax

Practice location:
  • Phone: 410-829-7809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SEAN LOGIE
Title or Position: OWNER
Credential: PH.D.
Phone: 410-200-8858