Individual provider Active NPI

Rachel Chandley, PH.D.

  • Clinical Psychologist
  • Toledo, OH
National Provider Identifier
1417483975
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7568 Issued in OH
Practice address
5965 Renaissance PL
Toledo, OH 43623-4728
Phone
(419) 882-5678
Fax
(419) 882-7446
NPI assigned
May 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7568 OH Primary

Addresses

Primary practice location

5965 Renaissance PL
Toledo, OH 43623-4728

Mailing address

5965 Renaissance PL
Toledo, OH 43623-4728
Phone (419) 882-5678

Other names 1

  • Rachel L Burgard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170712000995 OH Practitioner - Clinical Psychologist 6800165564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Miami Medical College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Behavioral Healthcare IncGroup PAC ID 9931178092, 5 clinicians

Practice addresses (Care Compare)

5965 Renaissance PL
Suite 1
Toledo, OH 43623-4728
Phone (419) 882-5678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7568OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Behavioral Healthcare Inc Clinical CurrentSince Oct 4, 2021 Accepting new patients

Locations

5965 Renaissance Pl
Ste 1
Toledo, OH 43623
Phone (419) 882-5678

5965 Renaissance Pl
Toledo, OH 43623
Phone (419) 882-5678

Organizations & group practices 1

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": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1417483975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 RENAISSANCE PL",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234728",
            "telephone_number": "419-882-5678",
            "fax_number": "419-882-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 RENAISSANCE PL",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234728",
            "telephone_number": "419-882-5678",
            "fax_number": "419-882-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLEY",
        "first_name": "RACHEL",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "7568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "BURGARD",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.