# AFFECT PROVIDER GROUP, P.S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043147549
- **Authorized official:** KARL RENEE MULLINGS (DIRECTOR OF COMPLIANCE)
- **Authorized official phone:** (951) 691-9101

## Contact information

- **Practice address:** 3800 PALUXY DR STE 404, TYLER, TX 75703-1617
- **Practice address phone:** (845) 769-8758
- **Mailing address:** PO BOX 96635, PHOENIX, AZ 85072-6635
- **Mailing address phone:** (845) 769-8758

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/07/2026
- **Last updated:** 08/13/2026