Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Leydi Tatiana Fonseca, LCSW

Individual provider Clinical Social Worker · NPI 1104449032

Leydi Tatiana Fonseca, LCSW is a Clinical Social Worker in Ithaca, New York. Qualified in 2018, 8 years ago. Works from 2 locations. Licensed in New Jersey, New York and Pennsylvania.

Years since qualifying
8
Licensed in
NJ, NY, PA
In the registry since
2020
Specialties on file
4
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

212 Highgate Rd
Ithaca, NY 14850-1436
Phone: (862) 264-9284
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 987 Delsea Dr, Franklinville, NJ 08322-2313 — (609) 358-1719

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 095562-01 (NY)
Clinical Social Worker Taxonomy 1041C0700X · Licence 44SC06006900 (NJ)
Clinical Social Worker Taxonomy 1041C0700X · Licence CW025475 (PA)
Social Worker Taxonomy 104100000X · Licence 44SL06397700 (NJ)

Record details

NPI number1104449032
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMay 27, 2020
Last updated in NPPESDecember 26, 2025
Certification dateDecember 26, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated

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