Provider Demographics
NPI:1356562409
Name:I THINK I CAN LEARNING CENTER, INC.
Entity type:Organization
Organization Name:I THINK I CAN LEARNING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRYBINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-398-4226
Mailing Address - Street 1:125 N RUBY LN
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:62208-1926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 N RUBY LN
Practice Address - Street 2:
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-1926
Practice Address - Country:US
Practice Address - Phone:618-398-4226
Practice Address - Fax:618-398-1759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO145960OtherBCBS MO
IL8220492OtherBCBS IL
IL=========OtherTRICARE
MO145960OtherBCBS MO