Active NPI
William Sisco, PSY.D.
- Clinical Psychologist
- Traverse City, MI
National Provider Identifier
1457801276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810005386
- Practice address
- 830 Cottageview Dr Ste 103
Traverse City, MI 49684-2373 - Phone
- (231) 631-7517
- NPI assigned
- Oct 4, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810005386 | VA | Primary |
Addresses
Primary practice location
830 Cottageview Dr Ste 103
Traverse City, MI 49684-2373
Mailing address
830 Cottageview Dr Ste 103
Traverse City, MI 49684-2373
Phone (231) 631-7517
Other practice location 1
6105D Arlington Blvd
Falls Church, VA 22044-2950
Phone (703) 819-6177
Other practice location 2
3793 Sandia Pl
Traverse City, MI 49684-4456
Phone (231) 631-7517
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810005386 | VA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ethan Siegel, Psy.D. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Falls Church, VA
- NPI 1215488911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1457801276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 COTTAGEVIEW DR STE 103",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842373",
"telephone_number": "231-631-7517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 COTTAGEVIEW DR STE 103",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842373",
"telephone_number": "231-631-7517"
}
],
"practiceLocations": [
{
"address_1": "6105D Arlington Blvd",
"address_purpose": "LOCATION",
"city": "Falls Church",
"state": "VA",
"postal_code": "220442950",
"country_code": "US",
"telephone_number": "703-819-6177",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3793 Sandia Pl",
"address_purpose": "LOCATION",
"city": "Traverse City",
"state": "MI",
"postal_code": "496844456",
"country_code": "US",
"telephone_number": "231-631-7517",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SISCO",
"first_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-04",
"last_updated": "2025-09-11",
"certification_date": "2021-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810005386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.