Provider Demographics
NPI:1144673971
Name:THINKBIG, LLC, PSC
Entity type:Organization
Organization Name:THINKBIG, LLC, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTING PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:S
Authorized Official - Middle Name:L
Authorized Official - Last Name:DEFAZIO
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:971-225-0114
Mailing Address - Street 1:16225 SW GAGE LN
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-5580
Mailing Address - Country:US
Mailing Address - Phone:971-225-0114
Mailing Address - Fax:270-626-2725
Practice Address - Street 1:16225 SW GAGE LN
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-5580
Practice Address - Country:US
Practice Address - Phone:971-225-0114
Practice Address - Fax:270-626-2725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-16
Last Update Date:2016-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TE1100X, 251S00000X
OR103TH0004X, 133NN1002X
MN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & SportsGroup - Multi-Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty