Individual provider Active NPI

Michelle Ines Tep

  • Clinical Social Worker
  • San Bernardino, CA
National Provider Identifier
1093678302
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ASW131490 Issued in CA
Practice address
570 W 4TH St Ste 210
San Bernardino, CA 92401-1409
Phone
(909) 804-8877
NPI assigned
Dec 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW131490 CA Primary

Addresses

Primary practice location

570 W 4TH St Ste 210
San Bernardino, CA 92401-1409

Mailing address

570 W 4TH St Ste 210
San Bernardino, CA 92401-1409
Phone (909) 804-8877

Other practice location 1

2271 Alpine Blvd Ste A
Alpine, CA 91901-1101
Phone (888) 688-0248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ASW131490CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clay Counseling & Family Therapy, Professional Corporation CurrentSince Dec 7, 2025 Accepting new patients
Clay Counseling Solutions, Inc. PastSince Dec 7, 2025 Accepting new patients

Locations

570 W 4th St
Ste 210
San Bernardino, CA 92401
Phone (909) 804-8877

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1093678302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 W 4TH ST STE 210",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011409",
            "telephone_number": "909-804-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 W 4TH ST STE 210",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011409",
            "telephone_number": "909-804-8877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2271 Alpine Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Alpine",
            "state": "CA",
            "postal_code": "919011101",
            "country_code": "US",
            "telephone_number": "888-688-0248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEP",
        "first_name": "MICHELLE",
        "middle_name": "INES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-03",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW131490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.