MEDICARE: ELIZABETH GRAHAM REITER LAPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPC016009	GA

General Provider Information

NPI Number	:	1689442220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH GRAHAM REITER LAPC

Provider Business Mailing Address
First Line	:	417 SHORTLEAF TRL
Second Line	:
City	:	MARTINEZ
State	:	GA
Zip	:	30907-3364
Country	:	US
Telephone Number	:	706-691-3941
Fax Number	:

Provider Business Practice Location Address
First Line	:	417 SHORTLEAF TRL
Second Line	:
City	:	MARTINEZ
State	:	GA
Zip	:	30907-3364
Country	:	US
Telephone Number	:	706-691-3941
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2023
Last Update Date	:	02/27/2026

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