MELISSA M SISCO (NPI# 1700830122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700830122 |
| Entity Type | Individual |
| Full Name | MELISSA M SISCO |
| Credential | LPC |
| Practice Address |
6858 Swinnea Rd Bldg 4 Southaven MS 38671-9493 |
| Practice Telephone | 6627725937 |
| Practice Fax Number | 6627725940 |
| Mailing Telephone | 6627725937 |
| Mailing Fax Number | 6627725940 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2019-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC0000000571 | TN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BCBS OF TN PROVIDER # | 4121026 | 01 |
| TN | MAGELLAN | 252567000 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678071 | Melissa Marie Sisco | Psychologist | Broughton State Hospital, 1000 S. Sterling Street, Morganton, NC 28655 | 2020-01-09 |
| 1205234192 | Melissa Sisco | Nurse Practitioner | 101 Forrest Crossing Blvd, Ste 101, Franklin, TN 37064-5429 | 2014-12-09 |
| Street Address |
6858 SWINNEA RD BLDG 4 |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-9493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447751946 | Marlo Dione Smith | Registered Nurse | 6858 Swinnea Rd Bldg 4, Southaven, MS 38671-9493 | 2018-02-21 |
| 1033626205 | Anna Kathryn Michell | Occupational Therapy Assistant | 6858 Swinnea Rd Bldg 4, Southaven, MS 38671-9493 | 2018-01-09 |
| 1649783283 | Jessica Rena Reed | Counselor | 6858 Swinnea Rd Bldg 4, Southaven, MS 38671-9493 | 2017-11-06 |
| 1124549118 | Regina Lashone Mccray | Speech-Language Pathologist | 6858 Swinnea Rd Bldg 4, Southaven, MS 38671-9493 | 2017-06-29 |
| 1730639907 | Renita Hogan | Counselor | 6858 Swinnea Rd Bldg 4, Southaven, MS 38671-9493 | 2016-10-11 |
| 1639496482 | Cynthia Jones | Counselor | 6858 Swinnea Rd Bldg 4, Southaven, MS 38671-9493 | 2010-05-03 |
| 1992832471 | William George Hanley | Occupational Therapist | 6858 Swinnea Rd Bldg 4, Southaven, MS 38671 | 2007-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
| Find all providers in zip 38671 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720502032 | Darby Walton | Counselor | 6858 Swinnea Rd Bldg 1b, Southaven, MS 38671-9493 | 2017-07-28 |
| 1255793014 | Dianne Cheah Cox | Counselor | 7145 Swinnea Rd Ste 2, Southaven, MS 38671-6380 | 2016-03-22 |
| 1861882409 | Mary Fox | Counselor | 975 Swinnea Rdg, Suite 3, Southaven, MS 38671-6013 | 2015-02-04 |
| 1811309222 | Melba Elissa Brown | Counselor | 7688 Rowan Ln Apt 8, Southaven, MS 38671-6700 | 2014-05-20 |
| 1316181365 | Claycon LLC | Counselor | 8829 Centre Street, Southaven, MS 38671 | 2009-04-21 |
| 1902089857 | Behavior, Attention, and Developmental Disabilities Consultants, LLC | Counselor | 5779 Getwell Rd Bldg D3, Southaven, MS 38672-6351 | 2007-12-14 |
| 1184827685 | Amy H Gallimore | Counselor | 1630 Custer Dr, Southaven, MS 38671-5229 | 2007-06-11 |
| 1982795290 | Jessica Irene Stockman | Counselor | 7075 Golden Oaks Loop W, Ste. 3, Southaven, MS 38671-9010 | 2006-09-28 |
| 1598865339 | Mae C Young | Counselor | 230 Goodman Rd E, Suite 102 Building 3, Southaven, MS 38671-5154 | 2006-09-22 |
| 1437114980 | Elizabeth Linebarger Storey | Counselor | 9164 Preakness Dr, Southaven, MS 38671-5347 | 2006-04-18 |
| Find all providers in SOUTHAVEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.