417 Psych, LLC
NPI 1699653022ActiveOrganization· Psychologist, Clinical· Springfield, MO
Psychologist, Clinical in Springfield, Missouri, registered in NPPES in August 2025. The authorized official on file is Rachael Herrington Roldan, PH.D., Owner/Ceo.
Overview
| NPI | 1699653022 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 25, 2025 |
| Last updated in NPPES | Aug 25, 2025 |
| Certified by provider | Aug 24, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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