Provider Demographics
NPI:1982578050
Name:MENTAL MATTERS SERVICES
Entity type:Organization
Organization Name:MENTAL MATTERS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SHAMIRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-754-3525
Mailing Address - Street 1:367 MARYDELL RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-4108
Mailing Address - Country:US
Mailing Address - Phone:443-754-3525
Mailing Address - Fax:
Practice Address - Street 1:367 MARYDELL RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-4108
Practice Address - Country:US
Practice Address - Phone:443-754-3525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty