Thinkbig, LLC, PSC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THINKBIG, LLC, PSC

Practice address

16225 SW Gage LN
Beaverton, OR 97006-5580

Phone

(971) 225-0114

Fax

(270) 626-2725

NPI assigned

Jul 16, 2016

Last updated

Jul 16, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. S L Defazio, M.S.

Title

Consulting Psychologist

Phone

(971) 225-0114

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1468627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468627200000",
    "number": "1144673971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16225 SW GAGE LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065580",
            "telephone_number": "971-225-0114",
            "fax_number": "270-626-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16225 SW GAGE LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065580",
            "telephone_number": "971-225-0114",
            "fax_number": "270-626-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THINKBIG, LLC, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-16",
        "last_updated": "2016-07-16",
        "status": "A",
        "authorized_official_last_name": "DEFAZIO",
        "authorized_official_first_name": "S",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CONSULTING PSYCHOLOGIST",
        "authorized_official_telephone_number": "971-225-0114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "OR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2016; 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.