Organization
AFFECT PROVIDER GROUP, P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA RENEE MULLINGS (DIRECTOR OF COMPLIANCE)
(845) 768-8758
Entity
Organization
Contact information
Practice address
127 S 1ST ST STE 205, GENEVA, IL 60134-2644
(845) 769-8758
Mailing address
1640 BORO PL FL 4, MC LEAN, VA 22102-3627
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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