Active NPI
Shannon Desena
- Behavior Analyst
- Port Orange, FL
National Provider Identifier
1073206579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 12365790
- Practice address
- 1166 Palm Springs CT
Port Orange, FL 32128-6947 - Phone
- (407) 613-4272
- NPI assigned
- May 31, 2023
- Last updated
- Oct 22, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 12365790 | FL | Primary |
Addresses
Primary practice location
1166 Palm Springs CT
Port Orange, FL 32128-6947
Mailing address
10220 Kristen Park Dr
Orlando, FL 32832-5855
Other practice location 1
5051 Castello Dr
Naples, FL 34103-8982
Phone (239) 465-8337
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12365790 | FL | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Puzzly ABA LLC | Behavior Analyst | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Behavior Analyst
- Port Orange, FL
- NPI 1912662115
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761091200000",
"number": "1073206579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10220 KRISTEN PARK DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328325855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1166 PALM SPRINGS CT",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321286947",
"telephone_number": "407-613-4272"
}
],
"practiceLocations": [
{
"address_1": "5051 Castello Dr",
"address_purpose": "LOCATION",
"city": "Naples",
"state": "FL",
"postal_code": "341038982",
"country_code": "US",
"telephone_number": "239-465-8337",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DESENA",
"first_name": "SHANNON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-31",
"last_updated": "2025-10-22",
"certification_date": "2025-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "12365790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.