Provider Demographics
NPI:1548451446
Name:KOCHTITZKY, RODNEY MORSE (MDIV)
Entity type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:MORSE
Last Name:KOCHTITZKY
Suffix:
Gender:M
Credentials:MDIV
Other - Prefix:MR
Other - First Name:ROD
Other - Middle Name:
Other - Last Name:KOCHTITZKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MDIV
Mailing Address - Street 1:3605 HILLSBORO PIKE
Mailing Address - Street 2:PASTORAL CENTER FOR HEALING
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2123
Mailing Address - Country:US
Mailing Address - Phone:615-385-3838
Mailing Address - Fax:
Practice Address - Street 1:3605 HILLSBORO PIKE
Practice Address - Street 2:PASTORAL CENTER FOR HEALING
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2123
Practice Address - Country:US
Practice Address - Phone:615-385-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCPT0042101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral