Destiny Skye Phernetton, M.S ., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1250-140 Issued in WI

Practice address

5325 Wall St Ste 1000
Madison, WI 53718-7983

Phone

(855) 444-5664

NPI assigned

Aug 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Center for Behavior Intervention, Inc

  • Behavior Analyst
  • Mokena, IL
  • NPI 1972873768
  NPD (past)
• KGH Consultation & Treatment, Inc.

  • Behavior Analyst
  • Deerfield, IL
  • NPI 1073840740
  NPD (past)

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1245886761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WHALEN RD STE A",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 WALL ST STE 1000",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537187983",
            "telephone_number": "855-444-5664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3113 W Beltline Hwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537132934",
            "country_code": "US",
            "telephone_number": "608-896-6810",
            "fax_number": "608-819-6811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHERNETTON",
        "first_name": "DESTINY",
        "middle_name": "SKYE",
        "credential": "M.S ., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-19-90748",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "1250-140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Pham, MD
• Hiep Steve Phan, MD
• Nicole Phegley, MS, LAT, OTC
• Jessica Phelan, ANP-BC
• John M Phelan, MD
• Kathryn Philabaum
• Jennifer L Philip
• Stephen George Philip, MD
• Allison A Philipps, APNP
• Constance Philipps, MD

• Behavior Analyst in Madison, WI
• Providers in Madison, WI by specialty
• Behavior Analyst in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.