Individual provider Active NPI

Maya Lynton Rake, LISW-CP

  • Mental Health Counselor
  • Columbia, SC
National Provider Identifier
1548626831
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10118 Issued in SC
Practice address
1415 Blanding St Ste 4
Columbia, SC 29201-2922
Phone
(803) 779-7500
Fax
(803) 779-7522
NPI assigned
Jan 4, 2016
Last updated
Oct 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10118 SC Primary

Addresses

Primary practice location

1415 Blanding St Ste 4
Columbia, SC 29201-2922

Mailing address

1415 Blanding St Ste 4
Columbia, SC 29201-2922
Phone (803) 779-7500

Other practice location 1

201 Deer Ridge Dr
Hopkins, SC 29061-9141
Phone (803) 673-8672

Other names 1

  • Maya Lynton Engh Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20200416003483 SC Practitioner - Clinical Social Worker 4688004500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1415 Blanding St
Suite 4
Columbia, SC 29201-2922
Phone 803779750024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10118SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Maya Rake, Lisw-CP LLC CurrentSince Feb 7, 2020 Accepting new patients

Locations

1415 Blanding St
Ste 4
Columbia, SC 29201
Phone (803) 779-7500

2221 Bull St
Columbia, SC 29201
Phone (803) 447-5403

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": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1548626831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 BLANDING ST STE 4",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012922",
            "telephone_number": "803-779-7500",
            "fax_number": "803-779-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 BLANDING ST STE 4",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012922",
            "telephone_number": "803-779-7500",
            "fax_number": "803-779-7522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Deer Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Hopkins",
            "state": "SC",
            "postal_code": "290619141",
            "country_code": "US",
            "telephone_number": "803-673-8672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAKE",
        "first_name": "MAYA",
        "middle_name": "LYNTON",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-04",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "10118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAYA",
            "last_name": "ENGH",
            "middle_name": "LYNTON",
            "credential": "LISW-CP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.