Destiny Peterson, PHD
NPI 1154865590ActiveIndividual· Psychologist· Oak Park, MI
Psychologist (PHD) with Life Skills Village PLLC, practicing in Oak Park, Michigan. Medicare paid $10,332 for services to 19 patients in 2024.
Overview
| NPI | 1154865590 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | Dec 5, 2016 |
| Last updated in NPPES | Jul 21, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 6301016731 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (MI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 19 |
|---|---|
| Services billed | 144 across 10 procedure codes |
| Paid by Medicare | $10,332 |
Education and affiliations
| Graduation year | 2017 |
|---|---|
| Medicare specialty | Clinical Psychologist |
| Telehealth | Offers telehealth |
Medical group
- Life Skills Village PLLCOak Park, MI · 8 clinicians
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