Individual provider Active NPI

Charlene Selsvold, LCSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1336460427
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 22648 Issued in CA
Practice address
317 Groveland Ave Unit 612
Minneapolis, MN 55403-3671
Phone
(619) 665-3035
NPI assigned
Jun 12, 2010
Last updated
Jan 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 985086 CO
Clinical Social Worker 1041C0700X LCS 22648 CA Primary

Addresses

Primary practice location

317 Groveland Ave Unit 612
Minneapolis, MN 55403-3671

Mailing address

317 Groveland Ave Unit 612
Minneapolis, MN 55403-3671
Phone (619) 665-3035

Other practice location 1

3511 Camino Del Rio S Ste 500
San Diego, CA 92108-4022
Phone (619) 665-3035

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
LCS 22648CAMDClinical Social Worker
985086COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1276300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1336460427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 GROVELAND AVE UNIT 612",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033671",
            "telephone_number": "619-665-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 GROVELAND AVE UNIT 612",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033671",
            "telephone_number": "619-665-3035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3511 Camino Del Rio S Ste 500",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921084022",
            "country_code": "US",
            "telephone_number": "619-665-3035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELSVOLD",
        "first_name": "CHARLENE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-12",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "985086",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 22648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.