Wyatt & Jackson Center for Change, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

WYATT & JACKSON CENTER FOR CHANGE, LLC

Practice address

2637 Ridgewood Road Suite 100
Jackson, MS 39216

Phone

(601) 981-8846

Fax

(601) 981-8873

NPI assigned

Jun 21, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Mollie L. Wyatt, PH.D.NPI 1497968911

Title

Owner

Phone

(601) 981-8846

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mollie Wyatt, PH.D.

  • Psychologist
  • Jackson, MS
  • NPI 1497968911
  NPD Authorized official

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1801316807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 RIDGEWOOD RD STE 100",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164922",
            "telephone_number": "601-981-8846",
            "fax_number": "601-981-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 RIDGEWOOD ROAD SUITE 100",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-981-8846",
            "fax_number": "601-981-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYATT & JACKSON CENTER FOR CHANGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "MOLLIE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-981-8846",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy M. Wright, M.D.
• Virginia Wright, M.D.
• Whitley Wright, PHARMD
• Mary Elizabeth Wroten
• Ben Hao Wu, PHD
• Wyatt & Walker LLC
• Josephine Wyatt Ashmead, M.D.
• Felicie G Wyatt, MD
• Julie P Wyatt, MD
• Mollie Wyatt, PH.D.

• Mental Health Counselor in Jackson, MS
• Providers in Jackson, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.