Provider Demographics
NPI:1780450031
Name:CONSCIOUS GARDEN COUNSELING LLC
Entity type:Organization
Organization Name:CONSCIOUS GARDEN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER-THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JESICA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-231-7183
Mailing Address - Street 1:1149 HILTON RD # 200
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-2838
Mailing Address - Country:US
Mailing Address - Phone:313-228-6404
Mailing Address - Fax:
Practice Address - Street 1:1149 HILTON RD # 200
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-2838
Practice Address - Country:US
Practice Address - Phone:313-228-6404
Practice Address - Fax:313-331-6824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-28
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty