National Provider Identifier Database

417 PSYCH LLC
Clinical

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.


Contact Information

417 PSYCH, LLC
1911 S NATIONAL AVE STE 401
SPRINGFIELD, MO65804-2213
Phone: 417-413-1724
Fax: 417-313-0722
Website:
Specialty Taxonomy Code
* Clinical 103TC0700X

* Indicates primary specialty

NPI Profile & details for 417 PSYCH, LLC

NPI Number 1699653022
Legal business name
LBN
417 PSYCH, LLC
Authorized official RACHAEL ROLDAN - (OWNER/CEO)
Entity Organization
Organization subpart No
Enumeration date 08/25/2025
Last updated 08/25/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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