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Active NPI 1104689736 Individual Practitioner Female Practitioner

Dedra Buteyn , LPC-IT

Counselor - Professional • Appleton, WI

Professional Overview & Biography Verified Profile Summary

Dedra Buteyn, LPC-IT is a registered healthcare professional specializing in Counselor - Professional in Appleton, WI. Practice services are available at 626 E LONGVIEW DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

626 E Longview Dr

Appleton, WI 549112130

Telephone 9202150107

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Appleton, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.1 Yrs
State Avg: 12.8 Yrs
Regional Practice Density
194 Specialists

Practicing in Appleton, WI (4511 Statewide)

Telehealth Adoption Rate
4.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-05-06
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License WI 7067-226

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Josette Smith , LPC

Counselor - Mental Health

NPI 1700671286

Licensed Professional Counselor

Megan Fluhr

Counselor - Mental Health

NPI 1730013079

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location May 06, 2026

Registered at 626 E LONGVIEW DR, APPLETON, WI 549112130 (Tel: 9202150107)

✅
NPI Profile Active February 05, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location February 05, 2024

Registered at 806 VALLEY RD STE 13, MENASHA, WI 549521012 (Tel: 9208727292)

📍
Updated Business Mailing Address February 05, 2024

Registered at W5457 RED CLOVER TRL, APPLETON, WI 549157291 (Tel: 9204705407)

👤
Provider Name / Credentials Updated February 05, 2024

Recorded as DEDRA BUTEYN, LPC-IT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 05, 2024

Counselor (License #7067-226 in WI)

🟢
Initial NPI Registration & Enumeration February 05, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104689736
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 05, 2024
Last Update: May 06, 2026
Sole Proprietor: No
Update or Correct Profile

Mailing Address

W5457 Red Clover Trl

Appleton, WI 549157291

Phone: 9204705407

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.