Healthcare Provider Details

I. General information

NPI: 1053059022
Provider Name (Legal Business Name): DANIEL LYNN ENNS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W 21ST ST
CONCORDIA KS
66901-5200
US

IV. Provider business mailing address

2001 CLAFLIN RD
MANHATTAN KS
66502-3415
US

V. Phone/Fax

Practice location:
  • Phone: 785-243-8900
  • Fax:
Mailing address:
  • Phone: 785-587-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-2323
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC04290
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: