Selenaann Milicant Kristine Griswold, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

179516 Issued in AK

Practice address

124 W Swanson Ave
Wasilla, AK 99654-6822

Phone

(907) 671-2884

Fax

(907) 600-5102

NPI assigned

Jun 4, 2020

Last updated

Apr 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Selenaann Milicant Kristine Baldwin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 26, 2022 through Oct 26, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• A Grace Like Rain Counseling Services of Alaska, LLC

  • Clinical Social Worker
  • Wasilla, AK
  • NPI 1982399481
  NPD

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1255955266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7362 W PARKS HWY # 339",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996239300",
            "telephone_number": "907-671-2884",
            "fax_number": "907-600-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 W SWANSON AVE",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546822",
            "telephone_number": "907-671-2884",
            "fax_number": "907-600-5102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 W 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995012018",
            "country_code": "US",
            "telephone_number": "907-444-5641",
            "fax_number": "907-531-7371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISWOLD",
        "first_name": "SELENAANN",
        "middle_name": "MILICANT KRISTINE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "179516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SELENAANN",
            "last_name": "BALDWIN",
            "middle_name": "MILICANT KRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Griffin
• Teresa Griffin
• Adam Grisham
• Sydney Grisham
• John Thomas Grissom II, M.D.
• David Groat
• Morgan Marlene Groendyke
• Keanna Gross
• Angelynn Lee Grower
• Jeremy Grube

• Clinical Social Worker in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.