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SHAMIA CLARK LCPC
NPI 1104615921
Counselor - Mental Health in Baltimore, MD

Active since May 06, 2025PECOS Enrolled
3608 OLD YORK RD, BALTIMORE, MD 21218(443) 455-0786 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2025, May 6, 2025 (2 updates tracked since 2025).

About Shamia Clark Lcpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAMIA CLARK LCPC (NPI 1104615921) is an individual mental health provider in Baltimore, Maryland, licensed in Maryland (LC15913) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1104615921
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSHAMIA CLARKCredential: LCPC
Location Address3608 OLD YORK RDBaltimore, MD 21218-2546
Mailing Address3608 Old York RdBaltimore, MD 21218-2546 · (443) 455-0786
Phone(443) 455-0786
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMay 6, 2025
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 11, 2025
✔ NPI 1104615921 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MD · LC15913
3608 OLD YORK RD, Baltimore, MD 21218
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shamia Clark Lcpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5294224747
PECOS Enrollment IDI20251027002038
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INTENTIONAL MINDS L.L.C
Counselor (Mental Health)
3608 OLD YORK RD
BALTIMORE, MD 21218
Baltimore City (443) 455-0786

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shamia Clark's NPI number?

The NPI number for Shamia Clark is 1104615921. It was assigned to this individual provider in the NPPES registry on May 6, 2025.

Where is Shamia Clark located?

Shamia Clark practices at 3608 Old York Rd, Baltimore, MD 21218. The listed phone number is (443) 455-0786.

What is Shamia Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Shamia Clark enrolled in Medicare?

Yes. Shamia Clark is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shamia Clark was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.