Leydi Tatiana Fonseca, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

095562-01 Issued in NY

Practice address

212 Highgate Rd
Ithaca, NY 14850-1436

Phone

(862) 264-9284

NPI assigned

May 27, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Acenda, Inc.

  • Mental Health Counselor
  • Glassboro, NJ
  • NPI 1982752333

  Clinical

  Medicare reassignment NPD
• Northern Compass Mental Health

  • Community/Behavioral Health Agency
  • Ithaca, NY
  • NPI 1659132801
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1104449032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 HIGHGATE RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501436",
            "telephone_number": "862-264-9284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HIGHGATE RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501436",
            "telephone_number": "862-264-9284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "987 Delsea Dr",
            "address_purpose": "LOCATION",
            "city": "Franklinville",
            "state": "NJ",
            "postal_code": "083222313",
            "country_code": "US",
            "telephone_number": "609-358-1719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "LEYDI",
        "middle_name": "TATIANA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06006900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW025475",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06397700",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095562-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• FLX Physical Therapy PLLC
• Charlotte Lee Flynn
• Yvonne D Fogarty, MS, CCC, SLP
• E James Fogel Jr., M.D.
• Timothy Dennis Foley, L.AC
• Dennis Fontaine
• Caitlin Foor-Pessin, MD
• Robert M Foote
• Sarah Foran
• Erin Forquer, PHD

• Clinical Social Worker in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.