Strange Fruit Psychotherapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

STRANGE FRUIT PSYCHOTHERAPY LLC

Doing business as

Strange Fruit Psychotherapy

Practice address

1204 E Pembroke Ave
Hampton, VA 23669-3226

Phone

(757) 240-7928

NPI assigned

Oct 31, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shervonne Evette Banks, LCSW

Title

Licensed Clinical Social Worker

Phone

(757) 240-7928

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Strange Fruit Psychotherapy Doing business as

Electronic endpoints 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Janine Louise Grayson, D.C

  • Chiropractor
  • Norfolk, VA
  • NPI 1588696231
  NPD (past)
• Randall Bruce Miers, D.C.

  • Chiropractor
  • Hampton, VA
  • NPI 1164509220
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1932816048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 COLISEUM XING",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665971",
            "telephone_number": "757-240-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 E PEMBROKE AVE",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236693226",
            "telephone_number": "757-240-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRANGE FRUIT PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-30",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "SHERVONNE",
        "authorized_official_middle_name": "EVETTE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "757-240-7928",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033398003",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.strangefruitpsychotherapy.com",
            "affiliation": "N",
            "endpointDescription": "www.strangefruitpsychotherapy.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1204 E Pembroke Ave",
            "city": "Hampton",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236693226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Strange Fruit Psychotherapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Louis B. Stokley, OTR
• Aaron Stover, DO, MBA
• Wesley Stowe, M.D,
• Sharee Lashell Stowes, FNP-BC
• Kathryn Cheryl Stoyer, LCSW
• Joy Dixon Strawn, MD
• Meghan Stringer, LPC
• Janet Hope Strobel, SLP
• Rachel Fontaine Stubblefield, PHARMD
• Jacquelenn Marie Stuhldreher, MD

• Clinical Social Worker in Hampton, VA
• Providers in Hampton, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.