Healthcare Provider Details

I. General information

NPI: 1821661331
Provider Name (Legal Business Name): JEANETT VELAZQUEZ REIGHT LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 05/28/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 HOSPITAL ST.
AUGUSTA ME
04330-7451
US

IV. Provider business mailing address

60 MARBLE POINT RD
MOUNT VERNON ME
04352-3432
US

V. Phone/Fax

Practice location:
  • Phone: 207-613-6329
  • Fax:
Mailing address:
  • Phone: 207-576-6407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC7865
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: