Candace Peterson, MS, OTRL

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

5201008338 Issued in MI

Practice address

14969 Farmbrook Dr
Plymouth, MI 48170-2745

Phone

(616) 308-0719

NPI assigned

Sep 26, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Progressive Pathways, LLC

  • Speech-Language Pathologist
  • Novi, MI
  • NPI 1629514054
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1124421771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39300 W 12 MILE RD STE 105",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313140",
            "telephone_number": "248-719-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14969 FARMBROOK DR",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702745",
            "telephone_number": "616-308-0719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39300 W 12 Mile Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483313140",
            "country_code": "US",
            "telephone_number": "616-308-0719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CANDACE",
        "credential": "MS, OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MI",
            "license": "5201008338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Peslar
• Anwyn Petek
• Brenda Peters, L.M.T.
• Whitney Peters
• Bryan Peterson, MA, LLP
• Fawne Peterson, MT
• Stacy Peterson
• Casey Petri
• Dhaval Petrolwala
• Adriana Petrucci, LMSW

• Pediatric Occupational Therapist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Pediatric Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.