MEDICARE: GROW AGAIN COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	101Y00000X	Counselor
3	101YA0400X	Addiction (Substance Use Disorder) Counselor
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1417690967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GROW AGAIN COUNSELING, LLC

Provider Business Mailing Address
First Line	:	6231 PGA BLVD STE 104 #2028
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418
Country	:	US
Telephone Number	:	561-614-6914
Fax Number	:

Provider Business Practice Location Address
First Line	:	6231 PGA BLVD STE 104 #2028
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418
Country	:	US
Telephone Number	:	561-614-6914
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JORDAN JULES JOACHIM
Credential	:
Telephone Number	:	954-773-3081

Provider Enumeration Date	:	04/13/2022
Last Update Date	:	02/26/2026

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