Active NPI
Real Psychological Services
- Counseling Psychologist
- Columbus, OH
National Provider Identifier
1972314151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- Legal business name
- REAL PSYCHOLOGICAL SERVICES
- Practice address
- 630 E Broad St
Columbus, OH 43215-3999 - Phone
- (614) 618-5955
- Fax
- (614) 618-5956
- NPI assigned
- Jan 16, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dwight David Tolliver
- Title
- Executive Director
- Phone
- (614) 618-5955
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | Primary |
Addresses
Primary practice location
630 E Broad St
Columbus, OH 43215-3999
Mailing address
630 E Broad St
Columbus, OH 43215-3999
Phone (614) 618-5955
Other practice location 1
6500 Rolling Hills Ln E
Grove City, OH 43123-9787
Phone (614) 937-2844
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250331002751 | OH | Part B Supplier - Clinic/Group Practice | 2567985559 |
Receives reassigned benefits from 2 practitioners Practice locations: Columbus, OH |
National Provider Directory
National Provider DirectoryLocations
630 E Broad St
Columbus, OH 43215
Phone (614) 565-4210
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Counselor
- Columbus, OH
- NPI 1609795871
-
- Professional Counselor
- Columbus, OH
- NPI 1770048696
-
- Clinical Social Worker
- Columbus, OH
- NPI 1093327082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736985600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1755648000000",
"number": "1972314151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 E BROAD ST",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432153999",
"telephone_number": "614-618-5955",
"fax_number": "614-618-5956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 E BROAD ST",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432153999",
"telephone_number": "614-618-5955",
"fax_number": "614-618-5956"
}
],
"practiceLocations": [
{
"address_1": "6500 Rolling Hills Ln E",
"address_purpose": "LOCATION",
"city": "Grove City",
"state": "OH",
"postal_code": "431239787",
"country_code": "US",
"telephone_number": "614-937-2844",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "REAL PSYCHOLOGICAL SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-16",
"last_updated": "2025-08-20",
"certification_date": "2025-08-20",
"status": "A",
"authorized_official_last_name": "TOLLIVER",
"authorized_official_first_name": "DWIGHT",
"authorized_official_middle_name": "DAVID",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "614-618-5955"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.