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General NPI Number Information
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NPI Number | 1881569762
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Entity Type | Organization
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Legal Business Name | WISE MINDBODY INSTITUTE PLLC
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 100 N HOWARD ST STE W
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City | SPOKANE
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State | WA
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Zip | 99201-0508
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Country | US
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Telephone | 504-688-9323
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Fax | 608-740-5963
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Provider Business Mailing Address
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Address Line | 627 OPELOUSAS AVE # 17
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City | NEW ORLEANS
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State | LA
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Zip | 70114-4343
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Country | US
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Telephone | 504-688-9323
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Fax | 608-740-5963
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Authorized Official
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Title or Position | CLINICAL OPERATIONS DIRECTOR
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Name | DR. ERICA VANSHANDER BUCKNER
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Credential | PH.D., LCSW, ACSW
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Telephone | 504-688-9323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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Taxonomy #4
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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Taxonomy #5
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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Taxonomy #6
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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Taxonomy #8
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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Taxonomy #9
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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Taxonomy #10
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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Taxonomy #11
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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