Individual provider Active NPI

Jenna Lynn Witkowski, LCSW

  • Clinical Social Worker
  • Buffalo, NY
National Provider Identifier
1922497494
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085-070-1 Issued in NY
Practice address
391 Washington St Ste 8
Buffalo, NY 14203-2108
Phone
(716) 361-8190
Fax
(716) 768-1829
NPI assigned
Jan 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 085-070-1 NY Primary

Addresses

Primary practice location

391 Washington St Ste 8
Buffalo, NY 14203-2108

Mailing address

391 Washington St Ste 8
Buffalo, NY 14203-2108
Phone (716) 361-8190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20180212000760 NY Order and Referring Only - Clinical Social Worker 3870853997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085070-1NYMDSocial Worker
085-070-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1922497494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 WASHINGTON ST STE 8",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142032108",
            "telephone_number": "716-361-8190",
            "fax_number": "716-768-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 WASHINGTON ST STE 8",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142032108",
            "telephone_number": "716-361-8190",
            "fax_number": "716-768-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITKOWSKI",
        "first_name": "JENNA",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085-070-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.