Willie Dwayne Doctor Jr., LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20933 Issued in MD

Practice address

9002 Phillip Dorsey Way
Columbia, MD 21045-5149

Phone

(301) 920-4514

NPI assigned

Aug 3, 2015

Last updated

Feb 24, 2025By 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

Other identifiers 1

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.

• Building Families for Children, Inc.

  • Case Management Agency
  • Columbia, MD
  • NPI 1396137766
  NPD (past)
• Building Families for Children, Inc.

  • Community/Behavioral Health Agency
  • Columbia, MD
  • NPI 1487046496
  NPD (past)

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1972989895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6211",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210456211",
            "telephone_number": "301-920-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9002 PHILLIP DORSEY WAY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455149",
            "telephone_number": "301-920-4514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7161 Columbia Gateway Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210462148",
            "country_code": "US",
            "telephone_number": "410-872-1050 x1080",
            "fax_number": "410-872-1047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOCTOR",
        "first_name": "WILLIE",
        "middle_name": "DWAYNE",
        "name_suffix": "Jr.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-03",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "20933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "608401000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lily Anh DO
• Dobbin Dental Suite
• Jabari Dobson
• Doclinq LLC (Doclinq)
• Doctor Beams Medical Home
• Doctors First Professional Corporation
• Doctors First, LLC (First Medical Associates)
• Dodek & Dodek DDS, LLC (Dodek Dental Group)
• Niki M Dodek, DDS
• Samuel M Dodek III, DDS

• Clinical Social Worker in Columbia, MD
• Providers in Columbia, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.