ILLUMINATE MENTAL HEALTH AND WELLNESS GROUP
NPI 1629959721
Counselor - Mental Health in Appleton, WI

Q: What is Illuminate Mental Health And Wellness Group's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Active since September 08, 2025

626 E LONGVIEW DR LOWR LEVEL, APPLETON, WI 54911(920) 215-2260(920) 308-0702 Get Directions Write a Review

NPPES record last updated: July 21, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 21, 2026, Sep 8, 2025 (2 updates tracked since 2025).

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About Illuminate Mental Health And Wellness Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ILLUMINATE MENTAL HEALTH AND WELLNESS GROUP (NPI 1629959721) is a healthcare organization registered as a mental health in Appleton, Wisconsin and active in the NPI registry since September 2025. The organization lists Dedra Buteyn, Owner, Therapist, as its authorized official.

NPPES Registry Identity

NPI1629959721

Entity TypeOrganization

Primary Taxonomy101YM0800X

Legal Business NameILLUMINATE MENTAL HEALTH AND WELLNESS GROUP

Location Address626 E LONGVIEW DR LOWR LEVELAppleton, WI 54911-2130

Mailing Address626 E Longview Dr Lowr LevelAppleton, WI 54911-2130 · (920) 215-2260 · Fax (920) 308-0702

Phone(920) 215-2260

Fax(920) 308-0702

Organization SubpartNo

Authorized OfficialDedra ButeynOwner, Therapist · (920) 215-2260

Enumeration DateSeptember 8, 2025

Last NPPES UpdateJuly 21, 20262 updates tracked since enumeration

NPPES CertifiedJuly 21, 2026

✔ NPI 1629959721 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

626 E LONGVIEW DR LOWR LEVEL, Appleton, WI 54911

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Illuminate Mental Health And Wellness Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Illuminate Mental Health And Wellness Group, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dedra Buteyn, LPC-IT

Mental Health Counselor

NPI 1104689736

626 E LONGVIEW DR
Appleton, WI 54911

(920) 215-0107

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Illuminate Mental Health And Wellness Group's NPI number?

The NPI number for Illuminate Mental Health And Wellness Group is 1629959721. It was assigned to this organization in the NPPES registry on September 8, 2025.

Where is Illuminate Mental Health And Wellness Group located?

Illuminate Mental Health And Wellness Group is located at 626 E Longview Dr Lowr Level, Appleton, WI 54911. The listed phone number is (920) 215-2260.

What is Illuminate Mental Health And Wellness Group's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Illuminate Mental Health And Wellness Group enrolled in Medicare?

Yes. Illuminate Mental Health And Wellness Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Illuminate Mental Health And Wellness Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Mental Health Counselor) reassigns their Medicare billing to Illuminate Mental Health And Wellness Group. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Illuminate Mental Health And Wellness Group accept?

Health plans from Anthem Blue Cross and Blue Shield list Illuminate Mental Health And Wellness Group as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Illuminate Mental Health And Wellness Group was last updated on July 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.