Organization Active NPI

I Think I Can Learning Center, Inc.

  • Child & Adolescent Psychiatry Physician
  • Fairview Heights, IL
National Provider Identifier
1356562409
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
I THINK I CAN LEARNING CENTER, INC.
Practice address
125 N Ruby LN
Fairview Heights, IL 62208-1926
Phone
(618) 398-4226
Fax
(618) 398-1759
NPI assigned
May 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lisa Grybinas
Title
Owner
Phone
(618) 398-4226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

125 N Ruby LN
Fairview Heights, IL 62208-1926

Mailing address

125 N Ruby LN
Fairview Heights, IL 62208-1926

Other identifiers 2

IdentifierTypeStateIssuer
145960OtherMOBCBS MO
8220492OtherILBCBS IL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356562409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N RUBY LN",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N RUBY LN",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081926",
            "telephone_number": "618-398-4226",
            "fax_number": "618-398-1759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I THINK I CAN LEARNING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRYBINAS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-398-4226"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MO",
            "identifier": "145960",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "8220492",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.