Healthcare Provider Details

I. General information

NPI: 1801745526
Provider Name (Legal Business Name): WISE MIND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 E FRONT ST STE 325
TRAVERSE CITY MI
49686-2527
US

IV. Provider business mailing address

PO BOX 5317
TRAVERSE CITY MI
49696-5317
US

V. Phone/Fax

Practice location:
  • Phone: 231-685-7198
  • Fax:
Mailing address:
  • Phone: 231-685-7198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANNA BURNS
Title or Position: OWNER/ CLINICIAN
Credential: LMSW
Phone: 231-685-7198