NPI 1104402064 · live from the CMS NPI Registry
Affect Therapeutics INC
Clinic/Center, Rehabilitation, Substance Use Disorder in Charlottesville, VA. National Provider Identifier 1104402064, active.
NPI record
| NPI | 1104402064 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Rehabilitation, Substance Use Disorder 261QR0405X |
| Practice location | 1001 Research Park Blvd Ste 100, Charlottesville, VA 22911 |
| Practice phone | 845-769-8758 |
| Mailing address | Po Box 96634, Phoenix, AZ 85072 |
| Enumerated | March 22, 2021 |
| Last updated | August 20, 2026 |
| Authorized official | Karla Mullings, Director Of Compliance |
| Other names | Affect Therapeutics |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Counselor, Professional | 101YP2500X | — |
| Social Worker, Clinical | 1041C0700X | — |
| Registered Nurse | 163W00000X | — |
| Psychiatry & Neurology, Addiction Medicine | 2084A0401X | — |
| Clinic/Center, Community Health | 261QC1500X | — |
| Clinic/Center, Mental Health (Including Community Mental Health Center) | 261QM0801X | — |
| Clinic/Center, Adult Mental Health | 261QM0850X | — |
| Clinic/Center, Rehabilitation, Substance Use Disorder primary | 261QR0405X | — |
| Nurse Practitioner, Community Health | 363LC1500X | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.