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General NPI Number Information
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NPI Number | 1760297733
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Entity Type | Organization
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Legal Business Name | RESTORATIVE RECOVERY, PLLC
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 1125 MOUNTAIN VIEW DR
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City | HARRISONBURG
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State | VA
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Zip | 22801-4454
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Country | US
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Telephone | 540-435-9113
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 MOUNTAIN VIEW DR
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City | HARRISONBURG
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State | VA
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Zip | 22801-4454
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. SHAY KYLE MITCHELL
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Credential | MSN, PMHNP-BC, APN
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Telephone | 540-435-9113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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