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
National Provider Directory
- Tax ID family
- Affect
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Mental Health Counselor |
101YM0800X | Yes | ||
| Professional Counselor |
101YP2500X | |||
| Social Worker |
104100000X | |||
| Clinical Social Worker |
1041C0700X | |||
| Psychiatric/Mental Health Nurse Practitioner |
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
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.