MEDICARE: ELIZABETH RHEA LCSW, LICSW

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	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker	CSW009933	GA

General Provider Information

NPI Number	:	1265171185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH RHEA LCSW, LICSW

Provider Business Mailing Address
First Line	:	119 E COURT SQ STE 210
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-2522
Country	:	US
Telephone Number	:	404-369-0736
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 E COURT SQ STE 210
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-2522
Country	:	US
Telephone Number	:	404-369-0736
Fax Number	:

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

Provider Enumeration Date	:	05/31/2022
Last Update Date	:	04/15/2026

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