Affect Provider Group P.S.C.

Organization Active NPI Mental Health Counselor · Philadelphia, PA

NPI 1093676538 · NPPES record last updated Apr 16, 2026

Key facts

NPI
1093676538
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Counselor 101YM0800X
Legal business name
AFFECT PROVIDER GROUP P.S.C.
Practice address
2 Logan SQ Ste 300
Philadelphia, PA 19103-2733
Phone
(845) 769-8758
NPI assigned
Nov 24, 2025
Organization subpart
No

Authorized official

Name
Karla Renee Mullings
Title
Dir. of Compliance
Phone
(845) 768-8758

Corporate family (same tax ID) 22

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Affect (23 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101Y00000X
Addiction (Substance Use Disorder) Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YA0400X
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YM0800X Yes
Professional Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YP2500X
Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
104100000X
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
1041C0700X
Psychiatric/Mental Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LP0808X

Addresses

Primary practice location

2 Logan SQ Ste 300
Philadelphia, PA 19103-2733

Mailing address

1640 Boro PL FL 4
MC Lean, VA 22102-3627
Phone (845) 769-8759

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Mental Health Counselor in Pennsylvania

Sources for this page

Verify at the official NPI Registry.