Individual provider Active NPI

Louise Berdan Chan, PH.D.

  • Clinical Psychologist
  • Delaware, OH
National Provider Identifier
1750426185
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P.07814 Issued in OH
Practice address
7420 Gooding Blvd Ste 100
Delaware, OH 43015-7086
Phone
(773) 706-1091
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.007984 IL
Clinical Psychologist 103TC0700X 2590 NC
Clinical Psychologist 103TC0700X P.07814 OH Primary

Addresses

Primary practice location

7420 Gooding Blvd Ste 100
Delaware, OH 43015-7086

Mailing address

7750A Diley Rd
Canal Winchester, OH 43110-7758
Phone (773) 706-1091

Other identifiers 1

IdentifierTypeStateIssuer
6107447MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071.007984ILMDClinical Psychologist
P.07814OHMDClinical Psychologist
2590NCMDOccupational Therapist

Interoperability endpoints

  • Direct secure messaging: louise.chan.2@26020.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1750426185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750A DILEY RD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431107758",
            "telephone_number": "773-706-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7420 GOODING BLVD STE 100",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430157086",
            "telephone_number": "773-706-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "LOUISE",
        "middle_name": "BERDAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007984",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2590",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "P.07814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6107447",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delaware, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.