| Longevity Holistic Wellness LLC | |
|
121 E Silver Spring Dr Ste 202 Whitefish Bay WI 53217-4762 | |
| (262) 292-1018 | |
| Not Available |
| Full Name | Longevity Holistic Wellness LLC |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 121 E Silver Spring Dr Ste 202, Whitefish Bay, Wisconsin |
| Authorized Official Name and Position | Mary Muhammad (CO-OWNER) |
| Authorized Official Contact | 2622921018 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity Holistic Wellness LLC 121 E Silver Spring Dr Ste 202 Whitefish Bay WI 53217-4762 Ph: (262) 292-1018 | Longevity Holistic Wellness LLC 121 E Silver Spring Dr Ste 202 Whitefish Bay WI 53217-4762 Ph: (262) 292-1018 |
| NPI Number | 1952028839 |
|---|---|
| Provider Enumeration Date | 10/21/2022 |
| Last Update Date | 01/02/2026 |
| Certification Date | 01/02/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952028839 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (NU) | Secondary |
| 101YM0800X | Counselor - Mental Health | (NU) | Primary |
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