DESTINY PETERSON PHD
NPI 1154865590
Psychologist in Oak Park, MI

Active since December 05, 2016PECOS EnrolledAccepts Medicare Assignment
25900 GREENFIELD RD STE 100, OAK PARK, MI 48237(248) 788-4300 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 21, 2022, Aug 24, 2017 (2 updates tracked since 2017).

About Destiny Peterson Phd NPPES

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

DESTINY PETERSON PHD (NPI 1154865590) is an individual psychologist in Oak Park, Michigan, licensed in Michigan (6301016731) and active in the NPI registry since December 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1154865590
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDESTINY PETERSONCredential: PHD
Location Address25900 GREENFIELD RD STE 100Oak Park, MI 48237-1297
Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560 · (616) 486-6790
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateDecember 5, 2016
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1154865590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MI · 6301016731
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
25900 GREENFIELD RD STE 100, Oak Park, MI 48237

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Destiny Peterson Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153687348
PECOS Enrollment IDI20171103000404
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Destiny Peterson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Community/Behavioral Health
25900 GREENFIELD RD, SUITE 100
Oak Park, MI 48237
  • Reassigned Medicare billing, Michigan enrollment
  • 16 clinicians in this Medicare group
Specialist
20010 FARMINGTON RD
Livonia, MI 48152
  • Reassigned Medicare billing, Michigan enrollment
  • 13 clinicians in this Medicare group

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
17 services16 patients

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
25900 GREENFIELD RD STE 100
OAK PARK, MI 48237
Physical Therapist
25900 GREENFIELD RD STE 100
OAK PARK, MI 48237
Social Worker (Clinical)
25900 GREENFIELD RD STE 100
OAK PARK, MI 48237
Occupational Therapist
25900 GREENFIELD RD STE 100
OAK PARK, MI 48237
Physical Therapist
25900 GREENFIELD RD STE 100
OAK PARK, MI 48237
Psychologist
25900 GREENFIELD RD STE 100
OAK PARK, MI 48237
Occupational Therapist
25900 GREENFIELD RD STE 100
OAK PARK, MI 48237
Speech-Language Pathologist
25900 GREENFIELD RD STE 100
OAK PARK, MI 48237

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 Destiny Peterson's NPI number?

The NPI number for Destiny Peterson is 1154865590. It was assigned to this individual provider in the NPPES registry on December 5, 2016.

Where is Destiny Peterson located?

Destiny Peterson practices at 25900 Greenfield Rd Ste 100, Oak Park, MI 48237. The listed phone number is (248) 788-4300.

What is Destiny Peterson's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Destiny Peterson enrolled in Medicare?

Yes. Destiny Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Destiny Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Destiny Peterson reassigns Medicare benefits to 2 organizations: Life Skills Village, PLLC (Oak Park, MI) and Summit Psychiatric Services, P.L.C. (Livonia, MI). Each 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 Destiny Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Destiny Peterson accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company, Priority Health and UnitedHealthcare list Destiny Peterson 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 Destiny Peterson was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.