MEDICARE: MR. JORDAN JOACHIM

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	101YM0800X	Mental Health Counselor	MH23718	FL

General Provider Information

NPI Number	:	1801542162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JORDAN JOACHIM

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2022
Last Update Date	:	01/30/2026

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Directions to “ MR. JORDAN JOACHIM ” Practice Location

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