Individual provider Active NPI

Savonn Tep, MSW, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1235562703
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW90531 Issued in CA
Practice address
631 Maple Ave Ste C
Los Angeles, CA 90014
Phone
(213) 680-6366
NPI assigned
Aug 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ACSW 72172 CA
Clinical Social Worker 1041C0700X LCSW90531 CA Primary

Addresses

Primary practice location

631 Maple Ave Ste C
Los Angeles, CA 90014

Mailing address

631 Maple Ave Ste C
Los Angeles, CA 90014-2211
Phone (213) 680-6363

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
ACSW 72172CAMDMental Health Counselor
LCSW90531CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1235562703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 MAPLE AVE STE C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900142211",
            "telephone_number": "213-680-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 MAPLE AVE STE C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90014",
            "telephone_number": "213-680-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEP",
        "first_name": "SAVONN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ACSW 72172",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW90531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.