NPI Code Details Logo

NPI 1871459776

NPI 1871459776 : CONSCIOUS CHOICES THERAPY : LIVONIA, MI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1871459776
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    CONSCIOUS CHOICES THERAPY 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/05/2026
-----------------------------------------------------
    Last Update Date     |    01/05/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    31560 SCHOOLCRAFT RD 
-----------------------------------------------------
    City                 |    LIVONIA
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    48150-1805
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    313-753-3298
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    31560 SCHOOLCRAFT RD 
-----------------------------------------------------
    City                 |    LIVONIA
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    48150-1805
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    313-753-3298
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CEO
-----------------------------------------------------
    Name                 |     BREANNA  BASSETT 
-----------------------------------------------------
    Credential           |    LMSW
-----------------------------------------------------
    Telephone            |    313-753-3298
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    1041C0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Social Worker
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.