Healthcare Provider Details

I. General information

NPI: 1831052844
Provider Name (Legal Business Name): GENDER AND SEXUALITY THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 7TH AVE STE 1106
NEW YORK NY
10019-0029
US

IV. Provider business mailing address

850 7TH AVE STE 1106
NEW YORK NY
10019-0029
US

V. Phone/Fax

Practice location:
  • Phone: 609-433-2826
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY CLARKE
Title or Position: MHC-LP
Credential:
Phone: 609-433-2826