Provider Demographics
NPI:1558060160
Name:VELEZ-NIEVES, JANNETTE
Entity Type:Individual
Prefix:
First Name:JANNETTE
Middle Name:
Last Name:VELEZ-NIEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3969 SOUTHEASTERN WAY STE C
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-2442
Mailing Address - Country:US
Mailing Address - Phone:803-851-4049
Mailing Address - Fax:
Practice Address - Street 1:3969 SOUTHEASTERN WAY STE C
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-2442
Practice Address - Country:US
Practice Address - Phone:803-851-4049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health