Healthcare Provider Details
I. General information
NPI: 1518821537
Provider Name (Legal Business Name): MINDSCAPE ABA AND EDUCATIONAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8708 GREEN APPLE CT
WAKE FOREST NC
27587-4835
US
IV. Provider business mailing address
8708 GREEN APPLE CT
WAKE FOREST NC
27587-4835
US
V. Phone/Fax
- Phone: 919-449-5485
- Fax:
- Phone: 919-449-5485
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAREN
DAWSON
Title or Position: BOARD CERTIFIED BEHAVIOR ANALYST
Credential: MSW, BCBA, LBA
Phone: 919-449-5485