Provider Demographics
NPI:1700550324
Name:ESPINOSA, OLIVIA (LCSW)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:968 HYACYNTH LN
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-5748
Mailing Address - Country:US
Mailing Address - Phone:224-723-8912
Mailing Address - Fax:
Practice Address - Street 1:28 S 5TH ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2111
Practice Address - Country:US
Practice Address - Phone:630-765-3214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0222011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical