Destiny L Page

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Practice address

14077 Fairmount Dr
Detroit, MI 48205-1269

Phone

(989) 293-1034

NPI assigned

Oct 21, 2025

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

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

{
    "created_epoch": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1134096308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14077 FAIRMOUNT DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482051269",
            "telephone_number": "989-293-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14077 FAIRMOUNT DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482051269",
            "telephone_number": "989-293-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "DESTINY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krysta Lin Paciocco, ARNP
• Packard Group II, Inc.
• Packard Group Inc
• Ranjitha Rai Padhiar, B.D.S, M.D.S
• Ramesh Padiyar, M.D.
• Ericka Gabrielle Page, M.A., CPC
• Imani Page
• Myron Curtis Page Jr., CNA
• Roseanne Elizabeth Paglia, PHARM.D.
• Hirak Pahari, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Detroit, MI
• Providers in Detroit, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.