| Express Yourself Mental Health Services | |
|
5616 Park Heights Ave Baltimore MD 21215-3969 | |
| (443) 847-0917 | |
| Not Available |
| Full Name | Express Yourself Mental Health Services |
|---|---|
| Speciality | Social Worker |
| Location | 5616 Park Heights Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Lacresha Reid White (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 4437174432 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Express Yourself Mental Health Services 54 Championship Ct Owings Mills MD 21117-5409 Ph: (443) 717-4432 | Express Yourself Mental Health Services 5616 Park Heights Ave Baltimore MD 21215-3969 Ph: (443) 847-0917 |
| NPI Number | 1861024580 |
|---|---|
| Provider Enumeration Date | 02/11/2020 |
| Last Update Date | 10/12/2021 |
| Certification Date | 10/12/2021 |
| Medicare PECOS PAC ID | 1951706472 |
|---|---|
| Medicare Enrollment ID | O20210823000323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861024580 | NPI | - | NPPES |
| 1821446956 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lacresha Reid White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821446956 PECOS PAC ID: 1456757533 Enrollment ID: I20210915002496 |
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