Melissa Marie Sisco, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

103360 Issued in NC

Practice address

8303 Six Forks Rd Ste 207
Raleigh, NC 27615-3094

Phone

(919) 245-7791

NPI assigned

Jan 9, 2020

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 9, 2020 through Dec 9, 2026

Medicare enrollment (NPD)

Not 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.

• Grotto Psychological Solutions, PC

  • Clinical Psychologist
  • Gastonia, NC
  • NPI 1275267072
  NPD Authorized official
• Breyta Psychological Services, P.a.

  • Psychologist
  • Raleigh, NC
  • NPI 1871076406
  NPD (past)

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1225678071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 CREEKSIDE DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280567118",
            "telephone_number": "704-915-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 SIX FORKS RD STE 207",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153094",
            "telephone_number": "919-245-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISCO",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "103360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Sipos, PHARMD
• Savannah Sipperly, PA
• Nicolas Edward Sirianni, PSYD
• Alan A. Sirk, PT
• Sis Your Uterus Matters
• Lindsey Jae Siska, DPT
• Sisu Living House
• Six Forks Rescue Squad, Inc.
• Emma Marie Sizemore
• Jane Sizemore, OTR/L

• Clinical Psychologist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.