Provider Demographics
NPI:1104253681
Name:PRYOR, SARAH BOUNDS (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:BOUNDS
Last Name:PRYOR
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:PEYTON
Other - Last Name:BOUNDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1978
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-1978
Mailing Address - Country:US
Mailing Address - Phone:410-749-1015
Mailing Address - Fax:410-749-1020
Practice Address - Street 1:12145 ELM ST
Practice Address - Street 2:
Practice Address - City:PRINCESS ANNE
Practice Address - State:MD
Practice Address - Zip Code:21853-1358
Practice Address - Country:US
Practice Address - Phone:410-651-2204
Practice Address - Fax:410-651-0790
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD145791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid
S118Medicare PIN
MD119591300Medicaid