Healthcare Provider Details

I. General information

NPI: 1770049223
Provider Name (Legal Business Name): GEORGIANNA DALE OLIVIERI LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. GEORGIANNA DALE OLIVIERI

II. Dates (important events)

Enumeration Date: 02/20/2019
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2242 HILLS OAK CT
LISLE IL
60532-0805
US

IV. Provider business mailing address

2242 HILLS OAK CT
LISLE IL
60532-0805
US

V. Phone/Fax

Practice location:
  • Phone: 630-346-7923
  • Fax:
Mailing address:
  • Phone: 630-346-7923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166001488
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number124090
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: