Provider Demographics
NPI:1164886131
Name:DALTON, OLIVIA ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:ANN
Last Name:DALTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:ANN
Other - Last Name:GUILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:518 PARK DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-6425
Mailing Address - Country:US
Mailing Address - Phone:413-636-8945
Mailing Address - Fax:
Practice Address - Street 1:618 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042
Practice Address - Country:US
Practice Address - Phone:717-274-2741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
PAPC016037101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor