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Organization
WISE MINDBODY INSTITUTE PLLC
Active
Organization
WISE MINDBODY INSTITUTE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERICA VANSHANDER BUCKNER PH.D., LCSW, ACSW (CLINICAL OPERATIONS DIRECTOR)
(504) 688-9323
Entity
Organization
Contact information
Practice address
100 N HOWARD ST STE W, SPOKANE, WA 99201-0508
(504) 688-9323
(608) 740-5963
Mailing address
627 OPELOUSAS AVE # 17, NEW ORLEANS, LA 70114-4343
(504) 688-9323
(608) 740-5963
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
1041S0200X
School Social Worker
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
225700000X
Massage Therapist
—
—
225C00000X
Rehabilitation Counselor
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/09/2025
Last updated
10/09/2025
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