Marcus Van Sickle, PH.D., ABPP, MPAP

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

340254 Issued in LA

Practice address

1050 Remount Rd BLDG 3107
North Charleston, SC 29406-3516

Phone

(571) 607-2055

NPI assigned

May 13, 2016

Last updated

Oct 24, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1043666506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9861 BROKEN LAND PKWY STE 100",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463031",
            "telephone_number": "202-209-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 REMOUNT RD BLDG 3107",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294063516",
            "telephone_number": "571-607-2055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 NNPTC Cir",
            "address_purpose": "LOCATION",
            "city": "Goose Creek",
            "state": "SC",
            "postal_code": "294456314",
            "country_code": "US",
            "telephone_number": "843-794-0071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN SICKLE",
        "first_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "PH.D., ABPP, MPAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-13",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "LA",
            "license": "340254",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prescribing (Medical) Psychologist in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Prescribing (Medical) Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.