Healthcare Provider Details

I. General information

NPI: 1477489284
Provider Name (Legal Business Name): JADE HEALING COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 RENAISSANCE COMMONS BLVD APT 2303
BOYNTON BEACH FL
33426-7222
US

IV. Provider business mailing address

1660 RENAISSANCE COMMONS BLVD APT 2303
BOYNTON BEACH FL
33426-7222
US

V. Phone/Fax

Practice location:
  • Phone: 561-695-8555
  • Fax:
Mailing address:
  • Phone: 561-695-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. STEFANIE SCANNELL
Title or Position: FOUNDER
Credential: LMHC, ATR, BCBA
Phone: 561-695-8555