Organization
AFFECT PROVIDER GROUP, P.S.C.
Active
Other names
Affect Provider Group, P.C., Affect Provider Group
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA RENEE MULLINGS LCADC III (DIRECTOR OF COMPLIANCE)
(845) 769-8758
Entity
Organization
Contact information
Practice address
116 N 3RD ST STE 3, DANVILLE, KY 40422-1691
(845) 769-8758
Mailing address
116 N 3RD ST STE 3, DANVILLE, KY 40422-1691
(951) 691-9101
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
01/14/2022
Last updated
09/22/2023
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