Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Destiny Peterson, PHD

Individual provider Psychologist · NPI 1154865590

Destiny Peterson, PHD is a Clinical Psychologist in Oak Park, Michigan. Qualified in 2017, 9 years ago. Practices with Life Skills Village PLLC, a 7-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
9
Licensed in
MI
In the registry since
2016
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

25900 Greenfield Rd Ste 100
Oak Park, MI 48237-1297
Phone: (248) 788-4300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 6301016731 (MI)

Record details

NPI number1154865590
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedDecember 5, 2016
Last updated in NPPESJuly 21, 2022
Mailing address100 Michigan St Ne, Mc 845, Grand Rapids, MI 49503-2560

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Life Skills Village Pllc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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