| Lesbian And Gay Community Services Center, Inc. | |
|
208 West 13th St New York NY 10011 | |
| (212) 620-7310 | |
| (212) 924-2657 |
| Full Name | Lesbian And Gay Community Services Center, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 208 West 13th St, New York, New York |
| Authorized Official Name and Position | Jeffrey Klein (CHIEF OPERATION OFFICER) |
| Authorized Official Contact | 6463581719 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lesbian And Gay Community Services Center, Inc. 208 West 13th St New York NY 10011 Ph: (212) 620-7310 | Lesbian And Gay Community Services Center, Inc. 208 West 13th St New York NY 10011 Ph: (212) 620-7310 |
| NPI Number | 1821801929 |
|---|---|
| Provider Enumeration Date | 01/31/2025 |
| Last Update Date | 04/11/2025 |
| Certification Date | 04/11/2025 |
| Medicare PECOS PAC ID | 9830614411 |
|---|---|
| Medicare Enrollment ID | O20250416000869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821801929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Mickey Correa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578801684 PECOS PAC ID: 5890929921 Enrollment ID: I20131003000493 |
| Provider Name | Sophia Glass |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477920965 PECOS PAC ID: 7416473863 Enrollment ID: I20250429000801 |
| Provider Name | Sebastien S Haizet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962116160 PECOS PAC ID: 9931627064 Enrollment ID: I20250513001629 |
| Provider Name | Lisa Donohue |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710153457 PECOS PAC ID: 8527349489 Enrollment ID: I20250519002695 |
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