Timothy Michael Doherty, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C002863 Issued in NC

Practice address

190 Kimel Park Dr
Winston-Salem, NC 27103-6946

Phone

(336) 768-3296

Fax

(336) 760-5484

NPI assigned

Mar 25, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Department of Veterans Affairs

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1073863197
  NPD (past)

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1740240431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 LUCERNE LN",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271042916",
            "telephone_number": "336-774-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 KIMEL PARK DR",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-768-3296",
            "fax_number": "336-760-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Doherty
• Ann Doherty, LPC
• Brittany Doherty, MS, CCC-SLP
• Jeanne A Doherty, MS, RDN, LDN
• Sean Patrick Doherty, MD
• Emily Lauren Dohoney, RD, LDN
• Matthew Dollyhite, BOCO
• Allison Dombroski, MD
• Melissa Corral Domenech, PA-C
• Brittany Ann Dominguez

• Clinical Social Worker in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.