NPIMap

Organization Active NPI

Shannon K Waliser Licsw Mpa LLC Dba Mind Body Wellness

  • Clinical Social Worker
  • Morgantown, WV
National Provider Identifier
1689818379
Registry record updated Jul 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
DP00942521 Issued in WV
Legal business name
SHANNON K WALISER LICSW MPA LLC DBA MIND BODY WELLNESS
Practice address
295 High St Ste 3
Morgantown, WV 26505-5449
Phone
(304) 363-4265
Fax
(304) 999-4826
NPI assigned
Apr 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2026

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

Authorized official

Name
Ms. Shannon Kristi Waliser, MSW, MPA, LICSW
Title
Owner
Phone
(304) 363-4265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X DP00942521 WV Primary

Addresses

Primary practice location

295 High St Ste 3
Morgantown, WV 26505-5449

Mailing address

295 High St Ste 3
Morgantown, WV 26505-5449
Phone (304) 363-4265

National Provider Directory

National Provider Directory

Locations

1042 Morgantown Ave
Ste 22
Fairmont, WV 26554
Phone (304) 363-4265

295 High St
Ste 3
Morgantown, WV 26505
Phone (304) 363-4265

235 High St
Ste 223
Morgantown, WV 26505
Phone (304) 363-4265

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784419200000",
    "number": "1689818379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 HIGH ST STE 3",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055449",
            "telephone_number": "304-363-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 HIGH ST STE 3",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055449",
            "telephone_number": "304-363-4265",
            "fax_number": "304-999-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON K WALISER LICSW MPA LLC DBA MIND BODY WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-24",
        "last_updated": "2026-07-19",
        "certification_date": "2026-07-19",
        "status": "A",
        "authorized_official_last_name": "WALISER",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "KRISTI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-363-4265",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, MPA, LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00942521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.