Healthcare Provider Details

I. General information

NPI: 1750202727
Provider Name (Legal Business Name): SHIRAH PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S YONGE ST STE 11C
ORMOND BEACH FL
32174-7586
US

IV. Provider business mailing address

397 MUDDY CREEK LN
ORMOND BEACH FL
32174-4895
US

V. Phone/Fax

Practice location:
  • Phone: 386-453-1454
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN KYLE SHIRAH
Title or Position: FOUNDER, MEMBER
Credential: DNP, APRN, PMHNP-BC
Phone: 386-453-1454