Healthcare Provider Details

I. General information

NPI: 1871459776
Provider Name (Legal Business Name): CONSCIOUS CHOICES THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29260 FRANKLIN RD STE 115
SOUTHFIELD MI
48034-1144
US

IV. Provider business mailing address

29260 FRANKLIN RD STE 115
SOUTHFIELD MI
48034-1144
US

V. Phone/Fax

Practice location:
  • Phone: 313-734-0062
  • Fax: 313-447-2406
Mailing address:
  • Phone: 313-734-0062
  • Fax: 313-447-2406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BREANNA BASSETT
Title or Position: CEO
Credential: LMSW
Phone: 313-734-0062