Individual provider Active NPI

Rodderick Deandre Dorsey-Williams, LCSW

  • School Social Worker
  • Washington, DC
National Provider Identifier
1700653078
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
LC200002982 Issued in DC
Practice address
1436 U St NW Ste 401
Washington, DC 20009-3988
Phone
(202) 506-5486
NPI assigned
Dec 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149023968 IL
School Social Worker 1041S0200X LC200002982 DC Primary

Addresses

Primary practice location

1436 U St NW Ste 401
Washington, DC 20009-3988

Mailing address

2219 Town Center Dr SE Apt 187
Washington, DC 20020-4033
Phone (312) 399-0412

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
149023968ILMDClinical Social Worker
LC200002982DCMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1700653078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 TOWN CENTER DR SE APT 187",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200204033",
            "telephone_number": "312-399-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 U ST NW STE 401",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200093988",
            "telephone_number": "202-506-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORSEY-WILLIAMS",
        "first_name": "RODDERICK",
        "middle_name": "DEANDRE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149023968",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "DC",
            "license": "LC200002982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.