Individual provider Active NPI

Michelle S Enriquez, LCSW

  • Clinical Social Worker
  • Montclair, CA
National Provider Identifier
1144810771
Registry record updated Apr 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
99482 Issued in CA
Practice address
5050 Palo Verde St Ste 128
Montclair, CA 91763-2334
Phone
(323) 940-7749
Fax
(323) 389-9094
NPI assigned
Jan 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 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 99482 CA Primary

Addresses

Primary practice location

5050 Palo Verde St Ste 128
Montclair, CA 91763-2334

Mailing address

2058 N Mills Ave # 112
Claremont, CA 91711-2812
Phone (323) 207-9012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231003003320 CA Practitioner - Clinical Social Worker 7315391745 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Psychological Services IncGroup PAC ID 1658744974, 13 clinicians

Practice addresses (Care Compare)

3633 Inland Empire Blvd
Suite 777
Ontario, CA 91764-7974
Phone (909) 295-5805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
99482CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Self Care Counseling Marriage Family and Child Therapy Inc. CurrentSince Aug 27, 2023 Accepting new patients
Thrive Psychological Services Inc CurrentSince Aug 29, 2023 Accepting new patients
Southern California Institute of Psychology, Inc. Clinical CurrentSince Mar 24, 2025 Accepting new patients

Locations

55 E Huntington Dr
Ste 218
Arcadia, CA 91006
Phone (213) 347-4740

1910 W Sunset Blvd
Ste 400
Los Angeles, CA 90026
Phone (213) 347-4356

5050 Palo Verde St
Ste 128
Montclair, CA 91763
Phone (323) 940-7749

3633 Inland Empire Blvd
Ste 777
Ontario, CA 91764
Phone (909) 235-5662

Organizations & group practices 4

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": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744416000000",
    "number": "1144810771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2058 N MILLS AVE # 112",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917112812",
            "telephone_number": "323-207-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 PALO VERDE ST STE 128",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632334",
            "telephone_number": "323-940-7749",
            "fax_number": "323-389-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "MICHELLE",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2025-04-12",
        "certification_date": "2025-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "99482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

Verify at the official NPI Registry.