National Provider Identifier
Leydi Tatiana Fonseca, LCSW
Leydi Tatiana Fonseca, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Ithaca, NY and a listed phone number of (862) 264-9284.
Profile Overview
- NPI
- 1104449032
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- May 27, 2020
- Last Updated
- December 26, 2025
Practice Location
- 212 Highgate RD
- Ithaca, NY 14850-1436
Phone: (862) 264-9284
Specialties
- Clinical Social Worker (1041C0700X)
- Clinical Social Worker (1041C0700X)
- Social Worker (104100000X)
Full Record
- NPI
- 1104449032
- Entity Type
- Individual
- Last Name
- Fonseca
- First Name
- Leydi
- Middle Name
- Tatiana
- Credential
- LCSW
- Mailing Street Address
- 212 Highgate RD
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1436
- Mailing Country
- US
- Mailing Phone
- (862) 264-9284
- Practice Street Address
- 212 Highgate RD
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1436
- Practice Country
- US
- Practice Phone
- (862) 264-9284
- Enumeration Date
- May 27, 2020
- Last Updated
- December 26, 2025
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- December 26, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X), Clinical Social Worker (1041C0700X), Social Worker (104100000X)