Healthcare Provider Details

I. General information

NPI: 1124701404
Provider Name (Legal Business Name): DARKLING PSYCHOTHERAPEUTIC SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38215 LANA DR
FARMINGTON HILLS MI
48335-2748
US

IV. Provider business mailing address

38215 LANA DR
FARMINGTON HILLS MI
48335-2748
US

V. Phone/Fax

Practice location:
  • Phone: 734-564-8876
  • Fax:
Mailing address:
  • Phone: 734-564-8876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TARA CONSOLINO
Title or Position: CEO, PSYCHOTHERAPIST
Credential: DSW, LMSW, MSW, PAI
Phone: 734-564-8876