WILLIE DWAYNE DOCTOR JR. LCSW-C
NPI 1972989895
Social Worker - Clinical in Columbia, MD

Active since August 03, 2015
9002 PHILLIP DORSEY WAY, COLUMBIA, MD 21045(301) 920-4514 Get Directions Write a Review

NPPES record last updated: February 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Willie Dwayne Doctor Jr. Lcsw-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLIE DWAYNE DOCTOR JR. LCSW-C (NPI 1972989895) is an individual clinical provider in Columbia, Maryland, licensed in Maryland (20933) and active in the NPI registry since August 2015. He maintains a secondary practice location in Columbia.

NPPES Registry Identity

NPI1972989895
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameWILLIE DWAYNE DOCTOR JR.Credential: LCSW-C
Location Address9002 PHILLIP DORSEY WAYColumbia, MD 21045-5149
Mailing AddressPo Box 6211Columbia, MD 21045-6211 · (301) 920-4514
Sole ProprietorNo
Enumeration DateAugust 3, 2015
Last NPPES UpdateFebruary 24, 2025
NPPES CertifiedFebruary 24, 2025
NPI 1972989895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in MD · 20933
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
9002 PHILLIP DORSEY WAY, Columbia, MD 21045

Secondary Practice Location 1

Location 17161 Columbia Gateway Dr Ste AColumbia, MD 21046-2148 · Phone (410) 872-1050 ext. 1080 · Fax (410) 872-1047

Other Identifiers 1

Medicaid608401000MD

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
9002 PHILLIP DORSEY WAY
COLUMBIA, MD 21045
Pharmacist (Psychiatric)
9002 PHILLIP DORSEY WAY
COLUMBIA, MD 21045

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willie Doctor's NPI number?

The NPI number for Willie Doctor is 1972989895. It was assigned to this individual provider in the NPPES registry on August 3, 2015.

Where is Willie Doctor located?

Willie Doctor practices at 9002 Phillip Dorsey Way, Columbia, MD 21045. The listed phone number is (301) 920-4514.

What is Willie Doctor's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Willie Doctor was last updated on February 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.