| Illuminate Mental Health Llc | |
|
626 E Longview Dr Lowr Level Appleton WI 54911-2130 | |
| (920) 215-2260 | |
| Not Available |
| Full Name | Illuminate Mental Health Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 626 E Longview Dr Lowr Level, Appleton, Wisconsin |
| Authorized Official Name and Position | Dedra M Buteyn (OWNER) |
| Authorized Official Contact | 9202152260 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuminate Mental Health Llc 626 E Longview Dr Lowr Level Appleton WI 54911-2130 Ph: (920) 215-2260 | Illuminate Mental Health Llc 626 E Longview Dr Lowr Level Appleton WI 54911-2130 Ph: (920) 215-2260 |
| NPI Number | 1083436067 |
|---|---|
| Provider Enumeration Date | 10/30/2024 |
| Last Update Date | 10/30/2024 |
| Certification Date | 10/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083436067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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