NPIMap

Organization Active NPI

Affect Provider Group P.S.C.

  • Mental Health Counselor
  • Indianapolis, IN
National Provider Identifier
1508748203
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
AFFECT PROVIDER GROUP P.S.C.
Practice address
863 Massachusetts Ave Ofc 220
Indianapolis, IN 46204-1610
Phone
(845) 769-8758
NPI assigned
Jul 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

863 Massachusetts Ave Ofc 220
Indianapolis, IN 46204-1610

Mailing address

1640 Boro PL FL 4
MC Lean, VA 22102-3627
Phone (845) 769-8758

Other names 1

  • Affect Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Affect23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Locations

863 Massachusetts Ave
Ofc 220
Indianapolis, IN 46204

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1508748203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 BORO PL FL 4",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023627",
            "telephone_number": "845-769-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "863 MASSACHUSETTS AVE OFC 220",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462041610",
            "telephone_number": "845-769-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFECT PROVIDER GROUP P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "MULLINGS",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "845-768-8758"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affect",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.