Individual provider Active NPI

Tyerell Dotson, LCSW, BCD

  • Clinical Social Worker
  • Richmond, VA
National Provider Identifier
1578102604
Registry record updated Jul 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904012976 Issued in VA
Practice address
1201 Broad Rock Blvd
Richmond, VA 23249-0001
Phone
(804) 675-5000
Fax
(804) 675-5870
NPI assigned
Jan 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X P013828 NC
Social Worker 104100000X 0903002709 VA
Clinical Social Worker 1041C0700X 112232 TX
Clinical Social Worker 1041C0700X 0904012976 VA Primary

Addresses

Primary practice location

1201 Broad Rock Blvd
Richmond, VA 23249-0001

Mailing address

7849 Sunset Blvd
Rowlett, TX 75088-1302
Phone (434) 660-5281

Other practice location 1

527 Tuskegee Airmen Ave, Bldg 500
Sheppard, TX 76311-3486
Phone (409) 676-6075

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

LicenseStateTypeSpecialty
P013828NCMDSocial Worker
0903002709VAMDSocial Worker
0904012976VAMDClinical Social Worker
112232TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753574400000",
    "number": "1578102604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7849 SUNSET BLVD",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750881302",
            "telephone_number": "434-660-5281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232490001",
            "telephone_number": "804-675-5000",
            "fax_number": "804-675-5870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "527 Tuskegee Airmen Ave, Bldg 500",
            "address_purpose": "LOCATION",
            "city": "Sheppard",
            "state": "TX",
            "postal_code": "763113486",
            "country_code": "US",
            "telephone_number": "409-676-6075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOTSON",
        "first_name": "TYERELL",
        "name_prefix": "Mr.",
        "credential": "LCSW, BCD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-07",
        "last_updated": "2025-07-27",
        "certification_date": "2025-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "P013828",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "0903002709",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "112232",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.