Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Corey John Ennis

Individual provider Mental Health Counselor · NPI 1851281794

Corey John Ennis is a Mental Health Counselor in Woodbury, Minnesota. Qualified in 2022, 4 years ago. Practices with Nystrom and Associates Ltd, a 617-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2025
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Practice location Address checks out

652 Bielenberg Dr Ste 103
Woodbury, MN 55125-4419
Phone: (612) 430-9181
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1851281794
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 3, 2025
Last updated in NPPESJuly 3, 2025
Certification dateJuly 3, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Nystrom And Associates Ltd — 617 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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