AFFECT PROVIDER GROUP P.S.C. — NPI 1033001656 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1033001656

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

101YM0800X (CMS E2)

Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor

Box 32 Service Location & ZIP+4

1640 BORO PL OFC 437, MC LEAN, VA, 22102-3626

✓ 9-Digit EDI 837 ZIP+4 (22102-3626)

Practice Phone & Referral Fax

(845) 769-8758

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1033001656 (AFFECT PROVIDER GROUP P.S.C.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1033001656` (NPI-2 Organization / Facility)
Provider / Legal Name	AFFECT PROVIDER GROUP P.S.C.
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor NUCC Code: `101YM0800X` (Counselor, Mental Health)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1640 BORO PL OFC 437, MC LEAN, VA, 22102-3626
Practice Telephone / Fax	Tel: (845) 769-8758
Administrative Mailing Address	1640 BORO PL FL 4, MC LEAN, VA, 22102-3627
Enumeration & Last Sync	Enumerated: 2025-07-17 \| CMS Record Updated: 2025-07-17
Authorized Official	KARLA MULLINGS (Director of Compliance)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1640 BORO PL OFC 437, MC LEAN, VA, 22102-3626

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Plain-English Taxonomy & CMS Crosswalk (101YM0800X)

What Does Taxonomy Code 101YM0800X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101YM0800X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor"

CMS-1500 Medicare Specialty Crosswalk: CMS Code E2 (Mental Health Counselor)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Counselor, Mental Health for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AFFECT PROVIDER GROUP P.S.C.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: N/A \| License: `Verified` \| Primary: Secondary
`1041C0700X` — Social Worker, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical	State: N/A \| License: `Verified` \| Primary: Secondary
`363LP0808X` — Nurse Practitioner, Psych/Mental Health Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health	State: N/A \| License: `Verified` \| Primary: Secondary
`101YM0800X` — Counselor, Mental Health Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AFFECT PROVIDER GROUP P.S.C. (NPI #1033001656)