Dedra Buteyn, LPC-IT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

7067-226 Issued in WI

Practice address

626 E Longview Dr
Appleton, WI 54911-2130

Phone

(920) 215-0107

NPI assigned

Feb 5, 2024

Last updated

May 6, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Illuminate Mental Health and Wellness Group

  • Mental Health Counselor
  • Appleton, WI
  • NPI 1629959721
  NPD Authorized official
• Illuminate Mental Health LLC

  • Mental Health Counselor
  • Appleton, WI
  • NPI 1083436067
  NPD Authorized official
• Couch Counseling Center, LLC

  • Mental Health Counselor
  • Menasha, WI
  • NPI 1467025965
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1104689736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5457 RED CLOVER TRL",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549157291",
            "telephone_number": "920-470-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 E LONGVIEW DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549112130",
            "telephone_number": "920-215-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTEYN",
        "first_name": "DEDRA",
        "credential": "LPC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7067-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Bushman, LCSW
• Nicole Bushman, LPC
• Brent Buss
• Meghan Olivia Bussiere
• Laura Marie Butch, NP
• Butte Des Morts Pathology, S.C.
• Janet Ann Butterbrodt, MS
• Suzanne M Butterfield, OTR
• Jena L Button, PTA
• Michael T Buyze, C.AC.

• Professional Counselor in Appleton, WI
• Providers in Appleton, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.