Affect Provider Group P.S.C.
Organization Active NPI Mental Health Counselor · New Berlin, WI
NPI 1114809274 · NPPES record last updated Jul 21, 2025
Key facts
- NPI
- 1114809274
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Legal business name
- AFFECT PROVIDER GROUP P.S.C.
- Practice address
- 2385 S 179TH St Ste C
New Berlin, WI 53146-2130 - Phone
- (845) 769-8758
- NPI assigned
- Jul 21, 2025
- Organization subpart
- No
Authorized official
- Name
- Karla Renee Mullings
- Title
- Director of Compliance
- Phone
- (845) 768-8758
Corporate family (same tax ID) 22
National Provider Directory
- Tax ID family
- Affect
Locations
2385 S 179th St
Ste C
New Berlin, WI 53146
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | Yes | ||
| Professional Counselor |
101YP2500X | |||
| Clinical Social Worker |
1041C0700X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X |
Addresses
Primary practice location
2385 S 179TH St Ste C
New Berlin, WI 53146-2130
Mailing address
1640 Boro PL FL 4
MC Lean, VA 22102-3627
Phone (845) 769-8758
Other names
- Affect
Other providers in New Berlin, WI
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- Advanced Healthcare, S.C.
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- Aegis Group Practice LLC
- Affiliated Dermatologists SC
- Alana Akam
- Trupti Akella
- Nathalie Gaby Akl
- Ejlal Alalawi
All providers in New Berlin, WI · Mental Health Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2025. 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.