Tyler Nathaniel Nicodem, M.A.

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

Practice address

5205 Maryland Way Ste 201
Brentwood, TN 37027-1008

Phone

(615) 601-1072

NPI assigned

Mar 8, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1003674631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 21ST AVE S STE 434",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372124353",
            "telephone_number": "615-601-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 MARYLAND WAY STE 201",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370271008",
            "telephone_number": "615-601-1072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 21st Ave S Ste 434",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372124353",
            "country_code": "US",
            "telephone_number": "615-601-1072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICODEM",
        "first_name": "TYLER",
        "middle_name": "NATHANIEL",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pastoral Counselor in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Pastoral Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.