Active NPI
Rakeyta Real, SSP, LPES
- School Psychologist
- Columbia, SC
National Provider Identifier
1538568233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 4816
- Practice address
- 1331 Elmwood Ave
Columbia, SC 29201-2150 - Phone
- (803) 250-5109
- NPI assigned
- Aug 19, 2014
- Last updated
- May 20, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 4816 | SC | Primary |
Addresses
Primary practice location
1331 Elmwood Ave
Columbia, SC 29201-2150
Mailing address
7625 Main St
Grovetown, GA 30813-1217
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4816 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia Psychological Services | School | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779235200000",
"number": "1538568233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7625 MAIN ST",
"city": "GROVETOWN",
"state": "GA",
"postal_code": "308131217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1331 ELMWOOD AVE",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292012150",
"telephone_number": "803-250-5109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REAL",
"first_name": "RAKEYTA",
"credential": "SSP, LPES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-19",
"last_updated": "2026-05-20",
"certification_date": "2026-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "SC",
"license": "4816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.