Organization
AFFECT PROVIDER GROUP P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA RENEE MULLINGS (DIR. OF COMPLIANCE)
(845) 768-8758
Entity
Organization
Contact information
Practice address
2 LOGAN SQ STE 300, PHILADELPHIA, PA 19103-2733
(845) 769-8758
Mailing address
1640 BORO PL FL 4, MC LEAN, VA 22102-3627
(845) 769-8759
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
11/24/2025
Last updated
04/16/2026
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