Melissa M Sisco, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC0000000571 Issued in TN

Practice address

6858 Swinnea Rd BLDG 4
Southaven, MS 38671-9493

Phone

(662) 772-5937

Fax

(662) 772-5940

NPI assigned

May 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Wellness Clinic, P.C.

  • Prescribing (Medical) Psychologist
  • Southaven, MS
  • NPI 1386860898
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1700830122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6858 SWINNEA RD BLDG 4",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719493",
            "telephone_number": "662-772-5937",
            "fax_number": "662-772-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6858 SWINNEA RD BLDG 4",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719493",
            "telephone_number": "662-772-5937",
            "fax_number": "662-772-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISCO",
        "first_name": "MELISSA",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "LPC0000000571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN PROVIDER #",
            "identifier": "4121026",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "252567000",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SOUTHAVEN",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6858 Swinnea Rd Bldg 4",
            "city": "Southaven",
            "state": "MS",
            "country_code": "US",
            "postal_code": "386719493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Simple Strokes Behavioral and Mental Health Group Inc
• Simple Strokes Therapy
• Simple Strokestherapy Consultants, PA
• Cody Allen Simpson, SFA
• Tavleen a Singh, MD
• Sisters Hospice & Palliative Care LLC
• Robert L Skinner, DO
• Tylar Skinner, RBT
• Sleep Diagnostics, LLC (The Reggie White Sleep Disorder Center - Desoto)
• Sleep Management Clinic, LLC

• Professional Counselor in Southaven, MS
• Providers in Southaven, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.