=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023964624
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ESSENTIAL HABITS FOR WELLNESS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/06/2026
-----------------------------------------------------
Last Update Date | 03/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | E884 STEVENS RD
-----------------------------------------------------
City | DE SOTO
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54624-6314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-385-7300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | E884 STEVENS RD
-----------------------------------------------------
City | DE SOTO
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54624-6314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-385-7300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRACTITIONER
-----------------------------------------------------
Name | ANNA MARIE SLABACK
-----------------------------------------------------
Credential | LPCC, LPC
-----------------------------------------------------
Telephone | 608-385-7300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------