Active NPI
Tyerell Dotson, LCSW, BCD
- Clinical Social Worker
- Richmond, VA
National Provider Identifier
1578102604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904012976
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| P013828 | NC | MD | Social Worker |
| 0903002709 | VA | MD | Social Worker |
| 0904012976 | VA | MD | Clinical Social Worker |
| 112232 | TX | MD | Speech-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.