Affect Provider Group P.S.C.
Counselor, Mental Health in Boston, MA. Organization (NPI-2).
NPI number1689554362
StatusActive
Last updated in NPPESAug 20, 2026
Details
- NPI
- 1689554362
- Entity type
- Organization (NPI-2)
- Legal business name
- Affect Provider Group P.S.C.
- Organization subpart
- No
- Enumeration date
- Sep 4, 2025
- Certification date
- Aug 20, 2026
- Last updated
- Aug 20, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
| 101YP2500X | Counselor, Professional | – | – | |
| 1041C0700X | Social Worker, Clinical | – | – | |
| 106H00000X | Marriage & Family Therapist | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Practice location
90 Canal St Ste 4Boston, MA 02114-2022
Phone 845-769-8758
Mailing address
Po Box 96635Phoenix, AZ 85072-6635
Phone 845-760-8758
Authorized official
Karla Renee Mullings
Director Of Compliance
8457688758
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