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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