Individual provider Active NPI

Kayla Ennett, PSY.D

  • Psychologist
  • Colorado Springs, CO
National Provider Identifier
1902336704
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY0006748 Issued in CO
Practice address
1880 Office Club PT Ste 225
Colorado Springs, CO 80920-5016
Phone
(619) 886-0633
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY0006748 CO Primary
Psychologist 103T00000X 5549-57 WI
Psychologist 103T00000X 14272867-2501 UT

Addresses

Primary practice location

1880 Office Club PT Ste 225
Colorado Springs, CO 80920-5016

Mailing address

10933 Torreys Peak Way
Peyton, CO 80831-4429
Phone (619) 886-0633

Other practice location 1

630 S 36th Ave
Wausau, WI 54401-3930
Phone (715) 842-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240311002257 CO Practitioner - Mental Health Counselor 6406292622 Reassigns benefits to 2 organizations
I20260331001809 WI Practitioner - Clinical Psychologist 6406292622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Behavioral Health Clinic LLCGroup PAC ID 8628409885, 43 clinicians

Practice addresses (Care Compare)

630 S 36TH Ave
Wausau, WI 54401-3930
Phone (715) 842-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY0006748COMDPsychologist
14272867-2501UTMDPsychologist
5549-57WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group of Colorado, PC Psychologist CurrentSince Jun 25, 2024 Accepting new patients
Mindful Therapy Group of Colorado, P.C. CurrentSince Jun 25, 2024 Accepting new patients
Sondermind Provider Network LLC Professional CurrentSince Jan 30, 2024 Accepting new patients

Locations

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

8490 E Crescent Pkwy
Ste 200
Greenwood Village, CO 80111
Phone (720) 316-6434

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

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": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1902336704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10933 TORREYS PEAK WAY",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808314429",
            "telephone_number": "619-886-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 OFFICE CLUB PT STE 225",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809205016",
            "telephone_number": "619-886-0633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 S 36th Ave",
            "address_purpose": "LOCATION",
            "city": "Wausau",
            "state": "WI",
            "postal_code": "544013930",
            "country_code": "US",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENNETT",
        "first_name": "KAYLA",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY0006748",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "5549-57",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "14272867-2501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.