Healthcare Provider Details

I. General information

NPI: 1740153600
Provider Name (Legal Business Name): R.E.A.L, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 W BURLEIGH ST
MILWAUKEE WI
53210-1516
US

IV. Provider business mailing address

5722 N 79TH ST
MILWAUKEE WI
53218-2105
US

V. Phone/Fax

Practice location:
  • Phone: 262-777-1435
  • Fax:
Mailing address:
  • Phone: 262-777-1435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. LAKEESHA BROWN
Title or Position: OWNER
Credential: LPC
Phone: 262-777-1435