Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

417 Psych, LLC

Organization Clinical Psychologist · NPI 1699653022

417 Psych, LLC is a Clinical Psychologist in Springfield, Missouri. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1911 S National Ave Ste 401
Springfield, MO 65804-2213
Phone: (417) 413-1724
Fax: (417) 313-0722
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X

Record details

NPI number1699653022
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rachael Roldan — Owner/Ceo · (417) 413-1724
NPI enumeratedAugust 25, 2025
Last updated in NPPESAugust 25, 2025
Certification dateAugust 24, 2025
Mailing address1911 S National Ave Ste 401, Springfield, MO 65804-2213

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