Healthcare Provider Details

I. General information

NPI: 1992665137
Provider Name (Legal Business Name): THOMAS JAMES KEKEISEN-CHEN DNP, PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 HAMMOND DRIVE BUILDING 14/SUITE 100
SANDY SPRINGS GA
30328
US

IV. Provider business mailing address

1012 HOMEWOOD CT
DECATUR GA
30033-4205
US

V. Phone/Fax

Practice location:
  • Phone: 678-615-7032
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberAPRN-NP340257
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: