Organization
INTENTIONAL MINDS L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAMIA CLARK LCPC, NCC (OWNER)
(443) 455-0786
Entity
Organization
Contact information
Practice address
3608 OLD YORK RD, BALTIMORE, MD 21218-2546
(443) 455-0786
Mailing address
3608 OLD YORK RD, BALTIMORE, MD 21218-2546
(443) 455-0786
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/11/2025
Last updated
09/11/2025
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