Provider Demographics
NPI:1629518600
Name:LEARNING LIGHTBULB INTERVENTIONS, LLC
Entity Type:Organization
Organization Name:LEARNING LIGHTBULB INTERVENTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THREASE
Authorized Official - Middle Name:
Authorized Official - Last Name:STUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA, LBA
Authorized Official - Phone:502-437-0640
Mailing Address - Street 1:77 MACK WALTERS RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1790
Mailing Address - Country:US
Mailing Address - Phone:502-437-0640
Mailing Address - Fax:502-317-0897
Practice Address - Street 1:77 MACK WALTERS RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1790
Practice Address - Country:US
Practice Address - Phone:502-437-0640
Practice Address - Fax:502-317-0897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty