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

Renew Restore Revise Psychiatric Services, LLC

Organization Psychiatry Physician · NPI 1891516324

Renew Restore Revise Psychiatric Services, LLC provides Psychiatry Physician services 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
Show map & directions

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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