Healthcare Provider Details

I. General information

NPI: 1033763214
Provider Name (Legal Business Name): RELATIONAL EXCELLENCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2019
Last Update Date: 07/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

898 AIRPORT PARK RD STE 101
GLEN BURNIE MD
21061-2521
US

IV. Provider business mailing address

898 AIRPORT PARK RD STE 101
GLEN BURNIE MD
21061-2521
US

V. Phone/Fax

Practice location:
  • Phone: 410-768-4386
  • Fax:
Mailing address:
  • Phone: 410-768-4386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JERIESHA JANELL HODGE
Title or Position: CEO/THERAPIST
Credential: MS LCPC CTRS
Phone: 202-531-0231