AFFECT THERAPEUTICS INC. NPI 1104402064

NPI Information

NPI: 1104402064
Provider Name: AFFECT THERAPEUTICS, INC.

Doing Business As: AFFECT THERAPEUTICS

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
1640 BORO PL FL 4
MC LEAN, VA
ZIP 22102
Phone: (845) 769-8758
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AFFECT THERAPEUTICS, INC. is a rehabilitation and substance use disorder clinic center in Mc Lean, VA. AFFECT THERAPEUTICS, INC. NPI is 1104402064. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Affect Therapeutics.

The provider's business location address is:

1640 BORO PL FL 4
MC LEAN, VA
ZIP 22102-627
Phone: (845) 769-8758

The provider's authorized official is Karla Renee Mullings .
The authorized official title is Director Of Compliance and has the following contact phone number (323) 522-2218.

The CLIA number assigned to this NPI record is 36D2241116 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/22/2021 and was last updated on 4/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	101YP2500X	Counselor	Professional	No
3	1041C0700X	Social Worker	Clinical	No
4	163W00000X	Registered Nurse		No
5	2084A0401X	Psychiatry & Neurology	Addiction Medicine	No
6	261QC1500X	Clinic/Center	Community Health	No
7	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
8	261QM0850X	Clinic/Center	Adult Mental Health	No
9	363LC1500X	Nurse Practitioner	Community Health	No
10	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	No
11	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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