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ALISHA SHANTEL CLARK LCPC
NPI 1114798683
Counselor - Mental Health in Parkville, MD

Active since January 12, 2024PECOS Enrolled
9613 HARFORD RD STE 3, PARKVILLE, MD 21234(410) 714-0775(443) 380-2886 Get Directions Write a Review

NPPES record last updated: January 9, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Alisha Shantel Clark Lcpc NPPES

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

ALISHA SHANTEL CLARK LCPC (NPI 1114798683) is an individual mental health provider in Parkville, Maryland, licensed in Maryland (LC17223) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1114798683
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameALISHA SHANTEL CLARKCredential: LCPC
Location Address9613 HARFORD RD STE 3Parkville, MD 21234-2150
Mailing Address2701 Jeremy Ct Apt ABaltimore, MD 21209-3062 · (443) 226-1966
Phone(410) 714-0775
Fax(443) 380-2886
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJanuary 12, 2024
Last NPPES UpdateJanuary 9, 2026
NPPES CertifiedJanuary 9, 2026
✔ NPI 1114798683 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 · LC17223
9613 HARFORD RD STE 3, Parkville, MD 21234
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID3375020654
PECOS Enrollment IDI20260116001429, I20260116001810
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Alisha Clark reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mosaic Community Services, Inc
4.3 mi
Mental Health (Including Community Mental Health Center)
9201 PHILADELPHIA RD
Baltimore, MD 21237
  • Reassigned Medicare billing, Maryland enrollment
  • 143 clinicians in this Medicare group
NPI 1124470067 (410) 574-7700
Way Station Inc
20 mi
Multi-Specialty
9030 STATE ROUTE 108 STE A
Columbia, MD 21045
  • Reassigned Medicare billing, Maryland enrollment
  • 132 clinicians in this Medicare group
NPI 1104914464 (410) 740-1901
Family Services, Inc
40 mi
Child & Adolescent Psychiatry
610 E DIAMOND AVE, SUITE 100
Gaithersburg, MD 20877
  • Reassigned Medicare billing, District of Columbia enrollment
  • 106 clinicians in this Medicare group
NPI 1780641928 (301) 840-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

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

BODY AND SOUL WELLNESS CENTER
Clinic/Center (Adult Mental Health)
9613 HARFORD RD STE 3
PARKVILLE, MD 21234
Baltimore County (443) 714-0775

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 Alisha Clark's NPI number?

The NPI number for Alisha Clark is 1114798683. It was assigned to this individual provider in the NPPES registry on January 12, 2024.

Where is Alisha Clark located?

Alisha Clark practices at 9613 Harford Rd Ste 3, Parkville, MD 21234. The listed phone number is (410) 714-0775.

What is Alisha Clark's specialty?

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

Is Alisha Clark enrolled in Medicare?

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

Which organizations bill Medicare for Alisha Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alisha Clark reassigns Medicare benefits to 3 organizations: Mosaic Community Services, Inc (Baltimore, MD), Way Station Inc (Columbia, MD) and Family Services, Inc (Gaithersburg, MD). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Alisha Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Alisha Clark was last updated on January 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.