Provider Demographics
NPI:1033093190
Name:WOVEN PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:WOVEN PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGATE-MAYS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-480-4072
Mailing Address - Street 1:350 REEDS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:MA
Mailing Address - Zip Code:01341-9713
Mailing Address - Country:US
Mailing Address - Phone:617-480-4072
Mailing Address - Fax:
Practice Address - Street 1:175 HARVEY ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1752
Practice Address - Country:US
Practice Address - Phone:617-480-4072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-02
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty