Healthcare Provider Details

I. General information

NPI: 1992629190
Provider Name (Legal Business Name): UJIMA ROOTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 BURNETT AVE APT 401
MAPLEWOOD NJ
07040-2985
US

IV. Provider business mailing address

92 BURNETT AVE APT 401
MAPLEWOOD NJ
07040-2985
US

V. Phone/Fax

Practice location:
  • Phone: 917-805-9823
  • Fax:
Mailing address:
  • Phone: 917-805-9823
  • Fax:

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: MALAIKA SMALL
Title or Position: CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 917-805-9823