Destiny Peterson, LMT

Primary specialty

SpecialistTaxonomy code 174400000X

License

7501000917 Issued in MI

Practice address

35560 Grand River Ave # 124
Farmington Hills, MI 48335-3123

Phone

(248) 564-7748

NPI assigned

Jan 15, 2015

Last updated

Sep 25, 2026By the provider in NPPES

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

Other identifiers 1

Other names 1

• Destiny Peterson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1366831273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35560 GRAND RIVER AVE # 124",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483353123",
            "telephone_number": "248-564-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35560 GRAND RIVER AVE # 124",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483353123",
            "telephone_number": "248-564-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DESTINY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "7501000917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN LICENSING BOARD NUMBER",
            "identifier": "7501000917",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESTINY",
            "last_name": "PETERSON",
            "credential": "LMT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Cherice Peterson
• Christian Peterson
• Courtney Peterson
• Darryl Peterson
• Davis Peterson
• Elizabeth Peterson
• Grace Peterson
• Katieanne Peterson
• Legend Peterson
• Leslie Peterson

• Specialist in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.