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Organization

AFFECT PROVIDER GROUP, P.S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KARL RENEE MULLINGS (DIRECTOR OF COMPLIANCE)
(951) 691-9101
Entity
Organization

Contact information

Practice address
3800 PALUXY DR STE 404, TYLER, TX 75703-1617
(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
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
1041C0700X
Clinical Social Worker
Primary
106H00000X
Marriage & Family Therapist
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
05/07/2026
Last updated
05/07/2026
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