Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Renew Restore Revise Psychiatric Services, LLC

Organization Psychiatry Physician · NPI 1891516324

Renew Restore Revise Psychiatric Services, LLC is a Psychiatry Physician in Palm Coast, Florida. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

25 Florida Park Dr N Ste E
Palm Coast, FL 32137-3806
Phone: (386) 585-2144
Fax: (386) 206-5386
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X

Record details

NPI number1891516324
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shinika Clark — Owner · (386) 585-2144
NPI enumeratedOctober 17, 2024
Last updated in NPPESOctober 1, 2025
Certification dateOctober 1, 2025
Mailing addressPo Box 45, St Augustine, FL 32085-0045

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