| Affect Therapeutics, Inc. | |
|
1640 Boro Pl Fl 4 Mc Lean VA 22102-3627 | |
| (845) 769-8758 | |
| Not Available |
| Full Name | Affect Therapeutics, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1640 Boro Pl Fl 4, Mc Lean, Virginia |
| Authorized Official Name and Position | Karla Renee Mullings (DIRECTOR OF COMPLIANCE) |
| Authorized Official Contact | 3235222218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Affect Therapeutics, Inc. 1640 Boro Pl Fl 4 Mc Lean VA 22102-3627 Ph: (845) 769-8758 | Affect Therapeutics, Inc. 1640 Boro Pl Fl 4 Mc Lean VA 22102-3627 Ph: (845) 769-8758 |
| NPI Number | 1104402064 |
|---|---|
| Provider Enumeration Date | 03/22/2021 |
| Last Update Date | 02/19/2025 |
| Certification Date | 02/19/2025 |
| Medicare PECOS PAC ID | 4284071903 |
|---|---|
| Medicare Enrollment ID | O20240318001200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104402064 | NPI | - | NPPES |
| Provider Name | Lori Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972870178 PECOS PAC ID: 4082852793 Enrollment ID: I20130607000065 |
| Provider Name | Kenyua Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669815478 PECOS PAC ID: 0941438998 Enrollment ID: I20170918001058 |
| Provider Name | Nonye Nwokoro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811544000 PECOS PAC ID: 0749618734 Enrollment ID: I20200325003638 |
| Provider Name | Tessie Eberhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992322168 PECOS PAC ID: 6507284304 Enrollment ID: I20200918000145 |
| Provider Name | Domonique Louis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720663701 PECOS PAC ID: 7416354378 Enrollment ID: I20210921001025 |
| Provider Name | Jerusha N Muniu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043830748 PECOS PAC ID: 2264863075 Enrollment ID: I20211028000329 |
| Provider Name | Lauren H. Grawert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508093543 PECOS PAC ID: 9436331139 Enrollment ID: I20230510000063 |
| Provider Name | Courtney Savard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326653460 PECOS PAC ID: 1052852092 Enrollment ID: I20240918001790 |
| Provider Name | Alison Greenlee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629665559 PECOS PAC ID: 9931633310 Enrollment ID: I20241107001379 |
| Provider Name | Roberta Russo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902572688 PECOS PAC ID: 1355724774 Enrollment ID: I20241108000091 |
| Provider Name | Brandy Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114232873 PECOS PAC ID: 3072638840 Enrollment ID: I20250224003439 |
Risa E. Sanders, Ph.d., Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1313 Vincent Pl, Mc Lean, VA 22101 Phone: 703-919-1959 | |
Sport Psychs Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8401 Greensboro Dr Ste 550, Mc Lean, VA 22102 Phone: 703-679-8249 | |
Affect Provider Group P.s.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1640 Boro Pl Ofc 437, Mc Lean, VA 22102 Phone: 845-769-8758 | |
Clementine Twin Lakes, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8180 Greensboro Dr Ste 375, Mc Lean, VA 22102 Phone: 571-569-4929 Fax: 571-762-0865 | |
Tysons Psychiatry Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8200 Greensboro Dr, Suite 120, Mc Lean, VA 22102 Phone: 703-782-4588 Fax: 703-782-4591 | |
Supportive Care Aba Va Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1765 Greensboro Station Pl, Mc Lean, VA 22102 Phone: 317-936-1240 Fax: 317-936-1241 | |
Psychological Wellness Services, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1489 Chain Bridge Rd Ste 300, Mc Lean, VA 22101 Phone: 203-819-7782 |