Organization
AFFECT PROVIDER GROUP, P.S.C.
Active
Other names
Affect Provider Group
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA RENEE MULLINGS (DIR. OF COMPLIANCE)
(845) 768-8758
Entity
Organization
Contact information
Practice address
12410 MILESTONE CENTER DR OFC 670, GERMANTOWN, MD 20876-7101
(951) 691-9101
Mailing address
1640 BORO PL FL 4, MC LEAN, VA 22102-3627
(951) 691-9101
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/25/2025
Last updated
05/06/2025
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