Provider Demographics
NPI:1003792458
Name:PERALA, TYLER (LMSW)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:PERALA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 131487
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48113-1487
Mailing Address - Country:US
Mailing Address - Phone:734-945-6210
Mailing Address - Fax:734-368-9115
Practice Address - Street 1:124 PEARL ST STE 207
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-5375
Practice Address - Country:US
Practice Address - Phone:734-945-6210
Practice Address - Fax:734-368-9115
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010983161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical