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417 PSYCH, LLC
NPI 1699653022
Psychologist - Clinical in Springfield, MO

Active since August 25, 2025
1911 S NATIONAL AVE STE 401, SPRINGFIELD, MO 65804(417) 413-1724(417) 313-0722 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About 417 Psych, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

417 PSYCH, LLC (NPI 1699653022) is a healthcare organization registered as a clinical in Springfield, Missouri and active in the NPI registry since August 2025. The organization lists Rachael Herrington Roldan, Owner/ceo, as its authorized official.

NPPES Registry Identity

NPI1699653022
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business Name417 PSYCH, LLC
Location Address1911 S NATIONAL AVE STE 401Springfield, MO 65804-2213
Mailing Address1911 S National Ave Ste 401Springfield, MO 65804-2213 · (417) 413-1724 · Fax (417) 313-0722
Phone(417) 413-1724
Fax(417) 313-0722
Organization SubpartNo
Authorized OfficialRachael Herrington RoldanOwner/ceo · (417) 413-1724
Enumeration DateAugust 25, 2025
NPPES CertifiedAugust 24, 2025
✔ NPI 1699653022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
1911 S NATIONAL AVE STE 401, Springfield, MO 65804
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RADIANT ALLY THERAPY & CONSULTING SERVICES, LLC
Clinic/Center (Adult Mental Health)
1911 S NATIONAL AVE STE 401
SPRINGFIELD, MO 65804
Greene County (417) 719-0973
DR. RACHAEL HERRINGTON ROLDAN PHD
Psychologist
1911 S NATIONAL AVE STE 401
SPRINGFIELD, MO 65804
Greene County (417) 413-1724

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 417 Psych, LLC's NPI number?

The NPI number for 417 Psych, LLC is 1699653022. It was assigned to this organization in the NPPES registry on August 25, 2025.

Where is 417 Psych, LLC located?

417 Psych, LLC is located at 1911 S National Ave Ste 401, Springfield, MO 65804. The listed phone number is (417) 413-1724.

What is 417 Psych, LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for 417 Psych, LLC was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.