Healthcare Provider Details

I. General information

NPI: 1821707167
Provider Name (Legal Business Name): KAYLEIGH M DARLING PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2022
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11280 86TH AVE N
MAPLE GROVE MN
55369-4510
US

IV. Provider business mailing address

11280 86TH AVE N
MAPLE GROVE MN
55369-4510
US

V. Phone/Fax

Practice location:
  • Phone: 763-400-7828
  • Fax: 763-400-7828
Mailing address:
  • Phone: 763-400-7828
  • Fax: 763-400-7828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP7332
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: