Individual ProviderWilliam C LottPsychologistBehavioral Health & Social Service ProvidersPractice Address969 Lakeland Dr, St Thomas Hall, Jackson, MS 39216-4606(601) 200-3110PECOS EnrollmentBased on the most recent information from CMS, provider William C Lott does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1891887808Provider TypeIndividualFull NameLott, William CCredentialPH.D.GenderMaleSole ProprietorNoEnumeration Date9/28/2006Last Updated4/30/2008Contact InformationPractice LocationPractice Address969 Lakeland Dr, St Thomas Hall, Jackson, MS 39216-4606Phone(601) 200-3110Fax(601) 200-3109Mailing LocationMailing AddressPO Box 23666, Jackson, MS 39225-3666Phone(601) 200-3110Fax(601) 200-3109Provider TaxonomiesCodeDescriptionLicenseCode103TC0700XPrimaryDescriptionPsychologistBehavioral Health & Social Service ProvidersLicense31466MississippiProvider IdentifiersIDDescriptionIssuerID01505748DescriptionMedicaidIssuerUnlistedMississippi