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Organization

417 PSYCH, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RACHAEL HERRINGTON ROLDAN PH.D. (OWNER/CEO)
(417) 413-1724
Entity
Organization

Contact information

Practice address
1911 S NATIONAL AVE STE 401, SPRINGFIELD, MO 65804-2213
(417) 413-1724
(417) 313-0722
Mailing address
1911 S NATIONAL AVE STE 401, SPRINGFIELD, MO 65804-2213
(417) 413-1724
(417) 313-0722

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
08/25/2025
Last updated
08/25/2025
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