Individual provider Active NPI

Tyler Sly, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1861034852
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801112405 Issued in MI
Practice address
3001 Plymouth Rd Ste 101
Ann Arbor, MI 48105-3205
Phone
(734) 307-0734
NPI assigned
Oct 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801112405 MI Primary

Addresses

Primary practice location

3001 Plymouth Rd Ste 101
Ann Arbor, MI 48105-3205

Mailing address

3001 Plymouth Rd Ste 101
Ann Arbor, MI 48105-3205
Phone (734) 307-0734

Other practice location 1

5340 Plymouth Rd Ste 104
Ann Arbor, MI 48105-9557
Phone (734) 307-0734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220825000361 MI Practitioner - Clinical Social Worker 1951785971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5340 Plymouth Rd
Suite 104
Ann Arbor, MI 48105-9557
Phone (734) 307-0734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801112405MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Sly Counseling Services Clinical CurrentSince Dec 1, 2024 Accepting new patients
County of Washtenaw PastSince Jan 1, 2021 Accepting new patients
County of Washtenaw PastSince Jan 1, 2021 Accepting new patients
Dawn Farm PastSince Oct 1, 2019 Accepting new patients
Dawn, Inc PastSince Oct 1, 2019 Accepting new patients

Locations

5340 Plymouth Rd
Ste 210
Ann Arbor, MI 48105
Phone (734) 335-4747

5340 Plymouth Rd
Ste 104
Ann Arbor, MI 48105
Phone (734) 335-4747

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1861034852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 PLYMOUTH RD STE 101",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481053205",
            "telephone_number": "734-307-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 PLYMOUTH RD STE 101",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481053205",
            "telephone_number": "734-307-0734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5340 Plymouth Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481059557",
            "country_code": "US",
            "telephone_number": "734-307-0734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLY",
        "first_name": "TYLER",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-11",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801112405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.