Healthcare Provider Details

I. General information

NPI: 1417690967
Provider Name (Legal Business Name): GROW AGAIN COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6231 PGA BLVD STE 104 #2028
PALM BEACH GARDENS FL
33418
US

IV. Provider business mailing address

6231 PGA BLVD STE 104 #2028
PALM BEACH GARDENS FL
33418
US

V. Phone/Fax

Practice location:
  • Phone: 561-614-6914
  • Fax:
Mailing address:
  • Phone: 561-614-6914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. JORDAN JULES JOACHIM
Title or Position: PRESIDENT
Credential:
Phone: 954-773-3081