| Wyatt & Walker LLC | |
|
2525 Lakeward Dr Ste 110 Jackson MS 39216-4827 | |
| (601) 981-8846 | |
| (601) 981-8873 |
| Full Name | Wyatt & Walker LLC |
|---|---|
| Speciality | Counselor |
| Location | 2525 Lakeward Dr Ste 110, Jackson, Mississippi |
| Authorized Official Name and Position | Catherine Ashy (BILLING MANAGER) |
| Authorized Official Contact | 6019538420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyatt & Walker LLC 2525 Lakeward Dr Ste 110 Jackson MS 39216-4827 Ph: (601) 981-8846 | Wyatt & Walker LLC 2525 Lakeward Dr Ste 110 Jackson MS 39216-4827 Ph: (601) 981-8846 |
| NPI Number | 1336815646 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 12/29/2025 |
| Certification Date | 12/29/2025 |
| Medicare PECOS PAC ID | 6901260801 |
|---|---|
| Medicare Enrollment ID | O20230911003776 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336815646 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| Provider Name | Mollie Wyatt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497968911 PECOS PAC ID: 7719341619 Enrollment ID: I20230911003808 |
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