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Organization
AFFECT PROVIDER GROUP P.S.C.
Active
Organization
AFFECT PROVIDER GROUP P.S.C.
Active
Other names
Affect
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA RENEE MULLINGS (DIRECTOR OF COMPLIANCE)
(845) 768-8758
Entity
Organization
Contact information
Practice address
2385 S 179TH ST STE C, NEW BERLIN, WI 53146-2130
(845) 769-8758
Mailing address
1640 BORO PL FL 4, MC LEAN, VA 22102-3627
(845) 769-8758
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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