Patricia Secoy Fontana, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2006016250 Issued in MO

Practice address

9962 Lin Ferry Dr
Saint Louis, MO 63123-6974

Phone

(626) 888-1112

NPI assigned

May 5, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Emotional Change Inc.

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1861753337
  NPD (past)

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

{
    "created_epoch": "1683244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1104515014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E LANGSNER ST",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342233454",
            "telephone_number": "314-974-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9962 LIN FERRY DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631236974",
            "telephone_number": "626-888-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECOY FONTANA",
        "first_name": "PATRICIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-05",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2006016250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Bahati Sebunyenzi, FNP
• Jonathan Charles Seccombe, M.D.
• Nicole Seckel, LPC
• Kaytlin Michelle Seckinger, ACNP
• Second Pair of Hands
• Emily Kathleen Secrist, MD
• Secure Home Health Services, LLC
• Secure Home Health Services, LLC
• Ashley Sedgwick Felton, ED.S
• Vedrana Sedic, DMD

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.