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LEYDI TATIANA FONSECA LCSW
NPI 1104449032
Social Worker - Clinical in Ithaca, NY

Active since May 27, 2020PECOS Enrolled
212 HIGHGATE RD, ITHACA, NY 14850(862) 264-9284 Get Directions Write a Review

NPPES record last updated: December 26, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 26, 2025, May 27, 2020 (2 updates tracked since 2020).

About Leydi Tatiana Fonseca Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEYDI TATIANA FONSECA LCSW (NPI 1104449032) is an individual clinical provider in Ithaca, New York, licensed in New York (095562-01) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS, maintains a secondary practice location in Franklinville, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1104449032
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameLEYDI TATIANA FONSECACredential: LCSW
Location Address212 HIGHGATE RDIthaca, NY 14850-1436
Mailing Address212 Highgate RdIthaca, NY 14850-1436 · (862) 264-9284
Phone(862) 264-9284
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateMay 27, 2020
Last NPPES UpdateDecember 26, 20252 updates tracked since enumeration
NPPES CertifiedDecember 26, 2025
✔ NPI 1104449032 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in NY · 095562-01✔ Licensed in NJ · 44SC06006900✔ Licensed in PA · CW025475
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedSocial WorkerTaxonomy 104100000X · License 44SL06397700 (NJ)
212 HIGHGATE RD, Ithaca, NY 14850
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Secondary Practice Location 1

Location 1987 Delsea DrFranklinville, NJ 08322-2313 · Phone (609) 358-1719

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Leydi Tatiana Fonseca Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1456741917
PECOS Enrollment IDI20260107000044
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14850 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.87 – $166.88
Typical copayment $0.00 (range $13.71 – $41.72)
Most-billed visit code NA
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NORTHERN COMPASS MENTAL HEALTH
Community/Behavioral Health
212 HIGHGATE RD
ITHACA, NY 14850
Tompkins County (862) 264-9284

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leydi Fonseca's NPI number?

The NPI number for Leydi Fonseca is 1104449032. It was assigned to this individual provider in the NPPES registry on May 27, 2020.

Where is Leydi Fonseca located?

Leydi Fonseca practices at 212 Highgate Rd, Ithaca, NY 14850. The listed phone number is (862) 264-9284.

What is Leydi Fonseca's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Leydi Fonseca enrolled in Medicare?

Yes. Leydi Fonseca is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Leydi Fonseca was last updated on December 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.