Organization · Type 2 NPI

Affect Provider Group P.s.c.

Mental Health Counselor · Salt Lake City, UT

NPI number 1417849548 Active

Practice location

10 W Broadway Fl 7
Salt Lake City, UT 84101-2060

Mailing address

1640 Boro Pl Fl 4
Mc Lean, VA 22102-3627

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed
Professional Counselor 101YP2500XNone listed
Clinical Social Worker 1041C0700XNone listed
Psychiatric/Mental Health Nurse Practitioner 363LP0808XNone listed

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About NPI 1417849548

Affect Provider Group P.s.c.'s National Provider Identifier is 1417849548, issued on Jul 15, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Salt Lake City, UT. The record was last updated on Jul 15, 2025.