Dedra Buteyn, LPC-IT
NPI 1104689736ActiveIndividual· Counselor, Professional· Appleton, WI
Counselor, Professional (LPC-IT) in Appleton, Wisconsin, licensed in WI, with an NPI issued in February 2024. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1104689736 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LPC-IT |
| Sole proprietor | No |
| NPI issued | Feb 5, 2024 |
| Last updated in NPPES | May 6, 2026 |
| Certified by provider | May 6, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | 7067-226 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (WI) |
|---|
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Mental Health Counselor |
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