Illuminate Mental Health and Wellness Group

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

ILLUMINATE MENTAL HEALTH AND WELLNESS GROUP

Practice address

626 E Longview Dr Lowr Level
Appleton, WI 54911-2130

Phone

(920) 215-2260

Fax

(920) 308-0702

NPI assigned

Sep 8, 2025

Last updated

Jul 21, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dedra Buteyn, LPCNPI 1104689736

Title

Owner, Therapist

Phone

(920) 215-2260

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dedra Buteyn, LPC-IT

  • Professional Counselor
  • Appleton, WI
  • NPI 1104689736
  NPD Authorized official
• Katie Schmidt, MA, LPC, CSW

  • Professional Counselor
  • Oshkosh, WI
  • NPI 1396296570
  NPD (past)

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1629959721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 E LONGVIEW DR LOWR LEVEL",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549112130",
            "telephone_number": "920-215-2260",
            "fax_number": "920-308-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 E LONGVIEW DR LOWR LEVEL",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549112130",
            "telephone_number": "920-215-2260",
            "fax_number": "920-308-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINATE MENTAL HEALTH AND WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "BUTEYN",
        "authorized_official_first_name": "DEDRA",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "920-215-2260",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Appleton, WI
• Providers in Appleton, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.