Destiny Peterson, PHD - Medicare Psychologist in Oak Park, MI

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Destiny Peterson, PHD is a medicare enrolled "Psychologist" provider in Oak Park, Michigan. She graduated from medical school in 2017 and has 7 years of diverse experience with area of expertise as Clinical Psychologist. She is a member of the group practice Life Skills Village Pllc and her current practice location is 25900 Greenfield Rd Ste 100, Oak Park, Michigan. You can reach out to her office (for appointments etc.) via phone at (248) 788-4300.

Destiny Peterson is licensed to practice in Michigan (license number 6301016731) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1154865590.

Contact Information

Destiny Peterson, PHD
25900 Greenfield Rd Ste 100,
Oak Park, MI 48237-1297
(248) 788-4300
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDestiny Peterson
GenderFemale
SpecialityClinical Psychologist
Experience7 Years
Location25900 Greenfield Rd Ste 100, Oak Park, Michigan
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Destiny Peterson graduated from medical school in 2017
  NPI Data:
  • NPI Number: 1154865590
  • Provider Enumeration Date: 12/05/2016
  • Last Update Date: 07/21/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 1153687348
  • Enrollment ID: I20171103000404

Medical Identifiers

Medical identifiers for Destiny Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1154865590NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist 6301016731 (Michigan)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Life Skills Village Pllc28606241035

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Destiny Peterson allows following entities to bill medicare on her behalf.
Entity NameSummit Psychiatric Services, P.l.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1821042789
PECOS PAC ID: 9234151366
Enrollment ID: O20060103000624
Entity NameLife Skills Village Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629316815
PECOS PAC ID: 2860624103
Enrollment ID: O20140421000357

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Destiny Peterson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Destiny Peterson, PHD
100 Michigan St Ne, Mc 845,
Grand Rapids, MI 49503-2560

Ph: (616) 486-6790		Destiny Peterson, PHD
25900 Greenfield Rd Ste 100,
Oak Park, MI 48237-1297

Ph: (248) 788-4300

Reviews and Comments


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Dr. Debora Ilene Rothbart, PSY.D.
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Dr. Olga Mikhaylovna Slavin-spenny, PH.D.
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Practice Location: 25900 Greenfield Rd Ste 502, Oak Park, MI 48237
Phone: 248-849-0050    
Austin Peter Vilk, TLLP
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Practice Location: 25900 Greenfield Rd Ste 100, Oak Park, MI 48237
Phone: 248-788-4300    
Marisa Mills, LLP
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Practice Location: 25900 Greenfield Rd Ste 100, Oak Park, MI 48237
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Practice Location: 25900 Greenfield Rd Ste 100, Oak Park, MI 48237
Phone: 248-788-4300    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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