# WOVEN ROOTS BEHAVIORAL HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477385508
- **Authorized official:** DR. JAMAL RASHAD CUNNINGHAM PSY.D., M.ED. (OWNER/LICENSED PSYCHOLOGIST)
- **Authorized official phone:** (301) 922-3930

## Contact information

- **Practice address:** 9120 W HAMPTON AVE STE 112, MILWAUKEE, WI 53225-4960
- **Practice address phone:** (301) 922-3930
- **Mailing address:** 9120 W HAMPTON AVE STE 112, MILWAUKEE, WI 53225-4960
- **Mailing address phone:** (301) 922-3930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | — | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | — | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 08/16/2024
- **Last updated:** 08/16/2024