Individual provider Active NPI

Lionel Norman Enns, PHD, BCBA-D, NCSP

  • Psychologist
  • Seattle, WA
National Provider Identifier
1881958148
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY60332197 Issued in WA
Practice address
4915 25TH Ave NE Ste 202W
Seattle, WA 98105-5668
Phone
(206) 697-1369
NPI assigned
Jul 1, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-12-12081
Cognitive & Behavioral Psychologist 103TB0200X
Clinical Child & Adolescent Psychologist 103TC2200X
Intellectual & Developmental Disabilities Psychologist 103TM1800X
School Psychologist 103TS0200X 473295D WA
Psychologist 103T00000X PY60332197 WA Primary

Addresses

Primary practice location

4915 25TH Ave NE Ste 202W
Seattle, WA 98105-5668

Mailing address

4822 38TH Ave NE
Seattle, WA 98105-3021
Phone (206) 697-1369

Other practice location 1

4822 38th Ave NE
Seattle, WA 98105-3021
Phone (206) 697-1369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Dec 20, 2023 through Dec 20, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY60332197WAMDPsychologist
473295DWAMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1341100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1881958148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4822 38TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053021",
            "telephone_number": "206-697-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 25TH AVE NE STE 202W",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055668",
            "telephone_number": "206-697-1369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4822 38th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981053021",
            "country_code": "US",
            "telephone_number": "206-697-1369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENNS",
        "first_name": "LIONEL",
        "middle_name": "NORMAN",
        "name_prefix": "Mr.",
        "credential": "PHD, BCBA-D, NCSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-12-12081",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "WA",
            "license": "473295D",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60332197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.