Provider Demographics
NPI:1447132337
Name:MINDSCAPE ABC LLC
Entity type:Organization
Organization Name:MINDSCAPE ABC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M. ED, ED. S
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KONESKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-494-6656
Mailing Address - Street 1:1011 SANDUSKY ST STE 1
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-3126
Mailing Address - Country:US
Mailing Address - Phone:419-494-6656
Mailing Address - Fax:
Practice Address - Street 1:1011 SANDUSKY ST STE 1
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-3126
Practice Address - Country:US
Practice Address - Phone:419-494-6656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty