Healthcare Provider Details

I. General information

NPI: 1689506909
Provider Name (Legal Business Name): ELEANOR MCRAE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7280 S 13TH ST STE 202
OAK CREEK WI
53154-1831
US

IV. Provider business mailing address

924 E JUNEAU AVE UNIT 323
MILWAUKEE WI
53202-6843
US

V. Phone/Fax

Practice location:
  • Phone: 262-251-1112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: