Provider Demographics
NPI:1164308847
Name:LAFONTAINE, LEAH KATHRYN (LSW)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:KATHRYN
Last Name:LAFONTAINE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2375 NEWTON RANSOM BLVD
Mailing Address - Street 2:
Mailing Address - City:RANSOM TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-9650
Mailing Address - Country:US
Mailing Address - Phone:607-351-2568
Mailing Address - Fax:
Practice Address - Street 1:41 N MAIN ST STE 307
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-2357
Practice Address - Country:US
Practice Address - Phone:570-209-9873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW140588104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker