Healthcare Provider Details

I. General information

NPI: 1982583324
Provider Name (Legal Business Name): SARAH MAZZUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MANCHESTER RD STE B
MANCHESTER MD
21102-1850
US

IV. Provider business mailing address

3000 MANCHESTER RD STE B
MANCHESTER MD
21102-1850
US

V. Phone/Fax

Practice location:
  • Phone: 410-861-0066
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP17397
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: