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General NPI Number Information
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NPI Number | 1578102604
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Entity Type | Individual
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Provider Name | TYERELL DOTSON LCSW, BCD
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Gender | Male
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 07/27/2025
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Provider Practice Location Address
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Address Line | 1201 BROAD ROCK BLVD
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City | RICHMOND
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State | VA
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Zip | 23249-0001
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Country | US
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Telephone | 804-675-5000
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Fax | 804-675-5870
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Provider Business Mailing Address
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Address Line | 7849 SUNSET BLVD
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City | ROWLETT
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State | TX
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Zip | 75088-1302
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Country | US
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Telephone | 434-660-5281
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | P013828
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 0903002709
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 112232
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904012976
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License Number State | VA
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