Provider Demographics
NPI:1740150424
Name:NIGHTSHADE COUNSELING, PLLC
Entity type:Organization
Organization Name:NIGHTSHADE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:G
Authorized Official - Last Name:DESLANDES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:586-344-0305
Mailing Address - Street 1:9933 LAWLER AVE STE 505
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-4302
Mailing Address - Country:US
Mailing Address - Phone:586-344-0305
Mailing Address - Fax:
Practice Address - Street 1:9933 LAWLER AVE STE 505
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-4302
Practice Address - Country:US
Practice Address - Phone:586-344-0305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-07
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty