GRACE MEDICAL & WELLNESS CLINIC, LLC – NPI #1609704840
Psychiatry & Neurology

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine

GRACE MEDICAL & WELLNESS CLINIC, LLC is a psychiatry & neurologist located in LAUREL, MS. NPPES recently assigned the NPI number 1609704840 to GRACE MEDICAL & WELLNESS CLINIC, LLC on May 09, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2084A0401X from the Health Care Provider Taxonomy code set, which is classified as Psychiatry & Neurology, specializing in Addiction Medicine Keep in mind, having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GRACE MEDICAL & WELLNESS CLINIC, LLC below.

NPI Profile for
GRACE MEDICAL & WELLNESS CLINIC, LLC

NPI Number
1609704840
Enumeration Date

(about 4 weeks ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GRACE MEDICAL & WELLNESS CLINIC, LLC
Primary location
1104 W 1ST ST STE 3
LAUREL, MS 39440-4357
Phone: (334) 580-0851 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
TINA NAYLOR
OWNER
Phone: (334) 580-0851
Updated
Certification Date
May 09, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.