Provider Demographics
NPI:1124701404
Name:DARKLING PSYCHOTHERAPEUTIC SERVICES, PLLC
Entity type:Organization
Organization Name:DARKLING PSYCHOTHERAPEUTIC SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONSOLINO
Authorized Official - Suffix:
Authorized Official - Credentials:DSW, LMSW, MSW, PAI
Authorized Official - Phone:734-564-8876
Mailing Address - Street 1:38215 LANA DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2748
Mailing Address - Country:US
Mailing Address - Phone:734-564-8876
Mailing Address - Fax:
Practice Address - Street 1:38215 LANA DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2748
Practice Address - Country:US
Practice Address - Phone:734-564-8876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health