Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tanja Ketisch

Individual provider Clinical Psychologist · NPI 1568844835

Tanja Ketisch is a Clinical Psychologist in Atlanta, Georgia. Practices as a sole proprietor. Licensed in Alabama and Georgia.

Licensed in
AL, GA
In the registry since
2015
Specialties on file
2

Practice location Address checks out

1160 Wing St
Atlanta, GA 30350-2953
Phone: (404) 423-5410
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY004088 (GA)
Clinical Psychologist Taxonomy 103TC0700X · Licence 1939 (AL)

Record details

NPI number1568844835
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 23, 2015
Last updated in NPPESJanuary 4, 2025
Certification dateJanuary 4, 2025

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