Jay Thames Moak, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

45-731 Issued in MS

Practice address

1701 White St
McComb, MS 39648-2711

Phone

(601) 684-2173

Fax

(601) 249-4234

NPI assigned

Jun 12, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Southwest Mississippi Mental Health Mental Retardation Commission

  • Social Worker
  • McComb, MS
  • NPI 1366694820
  NPD (past)
• 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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619919701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 768",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490768",
            "telephone_number": "601-249-2173",
            "fax_number": "601-249-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 WHITE ST",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482711",
            "telephone_number": "601-684-2173",
            "fax_number": "601-249-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOAK",
        "first_name": "JAY",
        "middle_name": "THAMES",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MS",
            "license": "45-731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mississippi State Department of Health
• Jon-Davis Williamson Mitchell, DO
• Michael Mitchell
• Stephanie Mixon
• Hanna Moak
• Monique Gloria Monard, M.D.
• Moore Vision Inc
• Charlotte Ann Moore
• Daisy Genolia Moore, M.S.
• James Stephen Moore, O.D.

• Clinical Psychologist in McComb, MS
• Providers in McComb, MS by specialty
• Clinical Psychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.