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General NPI Number Information
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NPI Number | 1194674523
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Entity Type | Organization
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Legal Business Name | REGULATE & RESTORE THERAPY LLC
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 777 N JEFFERSON ST STE SUITE 408 PMB1158
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City | MILWAUKEE
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State | WI
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Zip | 53202-3875
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Country | US
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Telephone | 262-228-4864
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Fax |
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Provider Business Mailing Address
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Address Line | 777 N JEFFERSON ST STE 408
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City | MILWAUKEE
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State | WI
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Zip | 53202-3875
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Country | US
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Telephone | 262-228-4864
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | TANYA EDWARDS
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Credential | LCSW
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Telephone | 262-228-4864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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