Mollie Wyatt, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

305 Issued in MS

Practice address

2525 Lakeward Dr Ste 110
Jackson, MS 39216-4827

Phone

(601) 981-8873

NPI assigned

May 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wyatt & Walker LLC

  • Mental Health Counselor
  • Jackson, MS
  • NPI 1336815646
  Medicare reassignment NPD
• Wyatt & Jackson Center for Change, LLC

  • Mental Health Counselor
  • Jackson, MS
  • NPI 1801316807
  NPD Authorized official
• SW Ms Mental Health Mental Retardation Commission

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • McComb, MS
  • NPI 1184662694
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1497968911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 LAKEWARD DR STE 110",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164827",
            "telephone_number": "601-981-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 LAKEWARD DR STE 110",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164827",
            "telephone_number": "601-981-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "MOLLIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MS",
            "license": "305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wyatt & Jackson Center for Change, LLC
• Wyatt & Walker LLC
• Josephine Wyatt Ashmead, M.D.
• Felicie G Wyatt, MD
• Julie P Wyatt, MD
• Hart Katherine Wylie, PMHNP, LPC
• Ashley Wynn
• Carrie S Wynn, MD
• James Wynn Sr., MD
• Xtreme Crowns Cranial Prosthetics by VXBL LLC

• Psychologist in Jackson, MS
• Providers in Jackson, MS by specialty
• Psychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.