Longevity Mental Health Group LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LONGEVITY MENTAL HEALTH GROUP LLC

Practice address

4611 Dogwood Springs LN Apt 104
Glen Allen, VA 23059-7639

Phone

(757) 610-8000

NPI assigned

Apr 2, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anthony Tyler

Title

Ceo

Phone

(804) 800-2500

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1316799620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 DOGWOOD SPRINGS LN APT 104",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230597639",
            "telephone_number": "804-800-2500",
            "fax_number": "804-800-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 DOGWOOD SPRINGS LN APT 104",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230597639",
            "telephone_number": "757-610-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "429 Thorncliff Dr",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236082301",
            "country_code": "US",
            "telephone_number": "804-800-2500",
            "fax_number": "804-800-2600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 Richneck Rd",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236083009",
            "country_code": "US",
            "telephone_number": "804-800-2500",
            "fax_number": "804-800-2600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Old Brick Rd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Glen Allen",
            "state": "VA",
            "postal_code": "230605841",
            "country_code": "US",
            "telephone_number": "804-800-2500",
            "fax_number": "804-800-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LONGEVITY MENTAL HEALTH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-02",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-800-2500"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30017798990001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cindy M. Logan, LCSW
• Logiss LLC
• Logistic & Distribution LLC
• Alan Lombardo, PHYSICAL THERAPIST
• Adrienne Long, LCSW, MSW
• William Anthony Loro, PT
• Anand P Lothe, MD
• Sharon Ann Lott, AU.D
• Alain Louka, R.PH.
• Karen Royal Love, M.D.

• Community/Behavioral Health Agency in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.