# PIVOTAL HEALTH AND WELLNESS CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700533890
- **Authorized official:** GRENISHA L YOUNG PMHNP-BC FNP-C (NURSE PRACTITIONER)
- **Authorized official phone:** (601) 397-6731

## Contact information

- **Practice address:** 110 CROSS PARK DR STE A, PEARL, MS 39208-9016
- **Practice address phone:** (601) 397-6731
- **Mailing address:** PO BOX 4244, BRANDON, MS 39047-4244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2022
- **Last updated:** 12/26/2025