Provider Demographics
NPI:1588422075
Name:DARLING, MARY-ELIZABETH GRACE
Entity type:Individual
Prefix:
First Name:MARY-ELIZABETH
Middle Name:GRACE
Last Name:DARLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY-ELIZABETH
Other - Middle Name:GRACE
Other - Last Name:MOZELESKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:515 E 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-3701
Mailing Address - Country:US
Mailing Address - Phone:248-548-4044
Mailing Address - Fax:
Practice Address - Street 1:515 E 11 MILE RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-3701
Practice Address - Country:US
Practice Address - Phone:248-548-4044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-08
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
MI6451024162101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program