Organization · Type 2 NPI
Grace Medical & Wellness Clinic, LLC
Addiction Medicine (Psychiatry & Neurology) Physician · Laurel, MS
NPI number
1609704840
Active
Practice location
1104 W 1st St Ste 3
Laurel, MS 39440-4357
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | None listed |
| Case Manager/Care Coordinator | 171M00000X | None listed |
| Family Medicine Physician | 207Q00000X | None listed |
| Addiction Medicine (Psychiatry & Neurology) Physician Primary | 2084A0401X | None listed |
| Clinic/Center | 261Q00000X | None listed |
| Adult Mental Health Clinic/Center | 261QM0850X | None listed |
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | None listed |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | None listed |
Addiction Medicine (Psychiatry & Neurology) Physician: 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
About NPI 1609704840
Grace Medical & Wellness Clinic, LLC's National Provider Identifier is 1609704840, issued on May 9, 2026. The primary taxonomy on file is Addiction Medicine (Psychiatry & Neurology) Physician (2084A0401X), and the practice location is in Laurel, MS. The record was last updated on May 9, 2026.