Provider Demographics
NPI:1699663344
Name:WINNICKI, JESSE WARREN (LMSW)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:WARREN
Last Name:WINNICKI
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3473 S PARK AVE LOT A16
Mailing Address - Street 2:
Mailing Address - City:BLASDELL
Mailing Address - State:NY
Mailing Address - Zip Code:14219-1000
Mailing Address - Country:US
Mailing Address - Phone:585-643-9331
Mailing Address - Fax:
Practice Address - Street 1:1001 11TH ST
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1201
Practice Address - Country:US
Practice Address - Phone:716-278-8110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)