Provider Type Icon

STRANGE FRUIT PSYCHOTHERAPY LLC NPI 1932816048


NPI Information

NPI: 1932816048
Provider Name: STRANGE FRUIT PSYCHOTHERAPY LLC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
1204 E PEMBROKE AVE
HAMPTON, VA
ZIP 23669
Phone: (757) 240-7928
Get Directions

STRANGE FRUIT PSYCHOTHERAPY LLC is a clinical social worker in Hampton, VA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. STRANGE FRUIT PSYCHOTHERAPY LLC NPI is 1932816048. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1204 E PEMBROKE AVE
HAMPTON, VA
ZIP 23669-226
Phone: (757) 240-7928

The provider's authorized official is Shervonne Evette Banks .
The authorized official title is Licensed Clinical Social Worker and has the following contact phone number (757) 240-7928.

The enumeration date for this NPI number is 10/31/2022 and was last updated on 10/31/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11033398003MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.