Grace Medical & Wellness Clinic, LLC

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

Legal business name

GRACE MEDICAL & WELLNESS CLINIC, LLC

Practice address

1104 W 1St St Ste 3
Laurel, MS 39440-4357

Phone

(334) 580-0851

NPI assigned

May 9, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tina NaylorNPI 1275314643

Title

Owner

Phone

(334) 580-0851

Specialties & licenses 8

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tina Naylor, PHD

  • Mental Health Counselor
  • Hattiesburg, MS
  • NPI 1275314643
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1778284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778284800000",
    "number": "1609704840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W 1ST ST STE 3",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404357",
            "telephone_number": "334-580-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 W 1ST ST STE 3",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404357",
            "telephone_number": "334-580-0851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL & WELLNESS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-09",
        "last_updated": "2026-05-09",
        "certification_date": "2026-05-09",
        "status": "A",
        "authorized_official_last_name": "NAYLOR",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-580-0851"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golden Touch Angels
• Franklin Golden
• Sergio G Gonzalez, MD
• Good Shepherd Medical/Dental Clinic
• Grace Counseling & Recovery Center, LLC
• Julian Kenneth Grafton Jr., M.D.
• Hannah Marie Grantham
• Jens Francis Graversen, M.D.
• Donna Green, R N
• Johnnie L Green, RN

• Addiction Medicine (Psychiatry & Neurology) Physician in Laurel, MS
• Providers in Laurel, MS by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.