NPI 1093676538 · live from the CMS NPI Registry
Affect Provider Group P.S.C.
Counselor, Mental Health in Philadelphia, PA. National Provider Identifier 1093676538, active.
NPI record
| NPI | 1093676538 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Mental Health 101YM0800X |
| Practice location | 2 Logan Sq Ste 300, Philadelphia, PA 19103 |
| Practice phone | 845-769-8758 |
| Mailing address | 1640 Boro Pl Fl 4, Mc Lean, VA 22102 |
| Enumerated | November 24, 2025 |
| Last updated | April 16, 2026 |
| Authorized official | Karla Mullings, Dir. Of Compliance |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | — |
| Social Worker, Clinical | 1041C0700X | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Social Worker | 104100000X | — |
| Counselor, Professional | 101YP2500X | — |
| Counselor, Mental Health primary | 101YM0800X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.