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GRACEFUL WELLNESS LLC
NPI 1952106882
Nurse Practitioner - Psychiatric/Mental Health in Jackson, MS

Active since February 14, 2025CLIA 25D2341079 · Waiver
2616 SOUTHERLAND ST STE 100, JACKSON, MS 39216(601) 953-1504(601) 866-1674 Get Directions Write a Review

NPPES record last updated: March 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 4, 2025, Feb 14, 2025 (2 updates tracked since 2025).

About Graceful Wellness Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACEFUL WELLNESS LLC (NPI 1952106882) is a healthcare organization registered as a psychiatric/mental health in Jackson, Mississippi and active in the NPI registry since February 2025. The organization holds a CLIA Waiver certificate valid through March 25, 2028 and lists Deidra Thompson, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1952106882
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameGRACEFUL WELLNESS LLC
Location Address2616 SOUTHERLAND ST STE 100Jackson, MS 39216-4855
Mailing Address1783 Jones LoopTerry, MS 39170-9013 · (601) 953-1504 · Fax (601) 866-1674
Phone(601) 953-1504
Fax(601) 866-1674
Organization SubpartNo
Authorized OfficialDeidra ThompsonManaging Member · (601) 953-1504
Enumeration DateFebruary 14, 2025
Last NPPES UpdateMarch 4, 20252 updates tracked since enumeration
NPPES CertifiedMarch 4, 2025
✔ NPI 1952106882 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
2616 SOUTHERLAND ST STE 100, Jackson, MS 39216
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2341079

Graceful Wellness PLLC · Flowood, MS
Active · expires Mar 25, 2028
CLIA Number25D2341079
Laboratory TypePhysician Office
Certificate Effective DateMarch 26, 2026
Certificate Expiration DateMarch 25, 2028
Laboratory DirectorDeidra L. Thompson
Laboratory Phone(601) 953-1504
Laboratory LocationGraceful Wellness PLLC1006 Top Street Suite A, Flowood, MS 39232
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACQUELINE D BOYD-DRUMMOND FNP-C
Nurse Practitioner
2616 SOUTHERLAND ST STE 100
JACKSON, MS 39216
Hinds County (601) 665-4429

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Graceful Wellness LLC's NPI number?

The NPI number for Graceful Wellness LLC is 1952106882. It was assigned to this organization in the NPPES registry on February 14, 2025.

Where is Graceful Wellness LLC located?

Graceful Wellness LLC is located at 2616 Southerland St Ste 100, Jackson, MS 39216. The listed phone number is (601) 953-1504.

What is Graceful Wellness LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Does Graceful Wellness LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2341079) is associated with this NPI, valid through March 25, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Graceful Wellness LLC was last updated on March 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.