Daelynn M Phares, MS, LPC-IT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2438-226 Issued in WI

Practice address

2901 Hunters TRL
Portage, WI 53901-3403

Phone

(608) 742-5518

Fax

(608) 268-9780

NPI assigned

Oct 18, 2024

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

Other names 1

• Daelynn M Butzler Former name

Medicare fee-for-service enrollment

Enrolled in WI

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Community Service Associates, SC

  dba Pauquette Center for Psychological Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portage, WI
  • NPI 1780610923
  Medicare reassignment NPD

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1689495095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 301",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539010301",
            "telephone_number": "608-742-5518",
            "fax_number": "608-268-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 HUNTERS TRL",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539013403",
            "telephone_number": "608-742-5518",
            "fax_number": "608-268-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHARES",
        "first_name": "DAELYNN",
        "middle_name": "M",
        "credential": "MS, LPC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "2438-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAELYNN",
            "last_name": "BUTZLER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Darrell R Parker, PA-C
• Hema Maurkumar Patel, MD
• Lorenzo Perez Romano, MD
• Ruthanne Perkins, OTR
• David P Perrodin, SLP
• Kym A Pharo, DNP, PMHNP-BC, FNP-B
• Yasmine Louise Phillips
• Carol Ada Pierce, MD
• Tammy Ann Pierner, M.D.
• Susan E Pineda, MD

• Mental Health Counselor in Portage, WI
• Providers in Portage, 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 Oct 18, 2024; 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.