Provider Demographics
NPI:1508675570
Name:RESTORATION PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:RESTORATION PSYCHIATRY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, WHNP-BC
Authorized Official - Phone:615-497-6874
Mailing Address - Street 1:40 SNAKE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37022-4672
Mailing Address - Country:US
Mailing Address - Phone:615-497-6874
Mailing Address - Fax:
Practice Address - Street 1:156 N WATER AVE STE 3
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2846
Practice Address - Country:US
Practice Address - Phone:615-524-1022
Practice Address - Fax:888-244-1057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-04
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)