Provider Demographics
NPI:1518465178
Name:REITER, NATALIE (LPC/LPCC)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:
Last Name:REITER
Suffix:
Gender:F
Credentials:LPC/LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4733 AMBER VALLEY PKWY S STE W
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8647
Mailing Address - Country:US
Mailing Address - Phone:701-248-5300
Mailing Address - Fax:
Practice Address - Street 1:4733 AMBER VALLEY PKWY S STE W
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8647
Practice Address - Country:US
Practice Address - Phone:701-248-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-30
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND642-9-1-09-225101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health