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

Destiny Peterson, PHD is a medicare enrolled "Psychologist" provider in Oak Park, Michigan. She graduated from medical school in 2017 and has 9 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 Name	Destiny Peterson
Gender	Female
Speciality	Clinical Psychologist
Experience	9 Years
Location	25900 Greenfield Rd Ste 100, Oak Park, Michigan
Accepts Medicare Assignments	Yes. 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.

Identifier	Type	State	Issuer
1154865590	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	6301016731 (Michigan)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Life Skills Village Pllc	2860624103	9

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 Name	Summit Psychiatric Services, P.l.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1821042789 PECOS PAC ID: 9234151366 Enrollment ID: O20060103000624

Entity Name	Life Skills Village Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI 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 Address	Practice 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

Psychologist in Oak Park, MI

Dr. Debora Ilene Rothbart, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 26031 Stratford Pl, Oak Park, MI 48237 Phone: 248-968-1162 Fax: 248-968-1162
Dr. Olga Mikhaylovna Slavin-spenny, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 25900 Greenfield Rd Ste 502, Oak Park, MI 48237 Phone: 248-849-0050
Austin Peter Giacomantonio, MA LLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 25900 Greenfield Rd Ste 100, Oak Park, MI 48237 Phone: 248-788-4300
Michelle Maree Mcgarrity, MA LLP Psychologist Medicare: Medicare Enrolled Practice Location: 21951 Whitmore St, Oak Park, MI 48237 Phone: 248-514-2017
Marisa Mills, LLP Psychologist Medicare: May Accept Medicare Assignments Practice Location: 25900 Greenfield Rd Ste 100, Oak Park, MI 48237 Phone: 248-788-4300
Cammi Shoultz, DLLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 25900 Greenfield Rd Ste 100, Oak Park, MI 48237 Phone: 248-788-4300 Fax: 248-605-8099

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