NPIMap

Organization Active NPI

Affect Provider Group, P.S.C.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Germantown, MD
National Provider Identifier
1962204644
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
AFFECT PROVIDER GROUP, P.S.C.
Practice address
12410 Milestone Center Dr Ofc 670
Germantown, MD 20876-7101
Phone
(951) 691-9101
NPI assigned
Mar 25, 2025
Last updated
Aug 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

12410 Milestone Center Dr Ofc 670
Germantown, MD 20876-7101

Mailing address

PO Box 96635
Phoenix, AZ 85072-6635
Phone (951) 691-9101

Other names 1

  • Affect Provider Group Other name

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

200 E Pratt St
Ofc 432
Baltimore, MD 21202

12410 Milestone Center Dr
Ofc 670
Germantown, MD 20876
Phone (951) 691-9101

NPI Registry JSON

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786665600000",
    "number": "1962204644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96635",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850726635",
            "telephone_number": "951-691-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12410 MILESTONE CENTER DR OFC 670",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208767101",
            "telephone_number": "951-691-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFECT PROVIDER GROUP, P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-25",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A",
        "authorized_official_last_name": "MULLINGS",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "DIR. OF COMPLIANCE",
        "authorized_official_telephone_number": "845-768-8758"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affect Provider Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Affect Provider Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.