NPI 1053226902 · live from the CMS NPI Registry
Express Yourself Black Man LLC
Social Worker, Clinical in Oakland, MD. National Provider Identifier 1053226902, active.
NPI record
| NPI | 1053226902 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 5000 Thayer Center, Ste C, Oakland, MD 21550 |
| Practice phone | 862-955-1109 |
| Mailing address | 3 Germay Dr, Ste 4, Unit #1798, Wilmington, DE 19804 |
| Enumerated | August 17, 2026 |
| Last updated | August 17, 2026 |
| Authorized official | Kofi Forson, Founder |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | — |
| Counselor, Mental Health | 101YM0800X | — |
| Counselor, Professional | 101YP2500X | — |
| Psychologist | 103T00000X | — |
| Social Worker, Clinical primary | 1041C0700X | — |
| Marriage & Family Therapist | 106H00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.