Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fitness Clinic Wellness

Organization Clinical Psychologist · NPI 1912352022

Fitness Clinic Wellness provides Clinical Psychologist services in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2016.

Licensed in
MS
In the registry since
2016
Specialties on file
3

Practice location Address checks out

2219 Greenway Dr
Jackson, MS 39204-3202
Phone: (601) 983-7494
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X
Clinical Psychologist Taxonomy 103TC0700X
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 871546 (MS)

Record details

NPI number1912352022
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Barbara Broadwater — Executive Director · (601) 983-7494
NPI enumeratedApril 26, 2016
Last updated in NPPESFebruary 9, 2017
Mailing address2219 Greenway Dr, Jackson, MS 39204-3202

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