Organization
LONGEVITY HOLISTIC WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MUHAMMAD LPC (CO-OWNER)
(262) 292-1018
Entity
Organization
Contact information
Practice address
121 E SILVER SPRING DR STE 202, WHITEFISH BAY, WI 53217-4762
(262) 292-1018
Mailing address
121 E SILVER SPRING DR STE 202, WHITEFISH BAY, WI 53217-4762
(262) 292-1018
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/21/2022
Last updated
01/02/2026
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