Provider Demographics
NPI:1770362600
Name:DOYLE, WILLIAM (LICSW)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:DOYLE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 BLADENSBURG RD NE STE 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2549
Mailing Address - Country:US
Mailing Address - Phone:202-441-9679
Mailing Address - Fax:
Practice Address - Street 1:1151 BLADENSBURG RD NE STE 101
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2549
Practice Address - Country:US
Practice Address - Phone:202-441-9679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500796321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical