OrganizationActive
417 Psych, LLC
NPI 1699653022 · Clinical Psychologist · Springfield, MO
Provider details
- NPI number
- 1699653022
- Entity type
- Organization
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Authorized official
- Rachael Roldan, Owner/Ceo
Practice location
1911 S National Ave Ste 401
Springfield, MO 65804-2213
Phone: (417) 413-1724
Fax: (417) 313-0722
Mailing address
1911 S National Ave Ste 401
Springfield, MO 65804-2213
Registry dates
- Enumerated
- 2025-08-25
- Last updated
- 2025-08-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.