Illuminate Mental Health and Wellness Group
NPI 1629959721ActiveOrganization· Counselor, Mental Health· Appleton, WI
Counselor, Mental Health in Appleton, Wisconsin, registered in NPPES in September 2025. The authorized official on file is Dedra Buteyn, LPC, Owner, Therapist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1629959721 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 8, 2025 |
| Last updated in NPPES | Jul 21, 2026 |
| Certified by provider | Jul 21, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Mental Health Primary | 101YM0800X | — | — |
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 Part B Supplier - Clinic/Group Practice (WI) |
|---|
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