Shannon Mary Caicedo

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-24-387446 Issued in FL

Practice address

1060 W State Road 434 Ste 108
Longwood, FL 32750-4953

Phone

(407) 324-7772

NPI assigned

Jan 14, 2025

Last updated

Jan 14, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Blue Path ABA

  dba Applied Behavior Center

  • Behavior Analyst
  • Longwood, FL
  • NPI 1891950671
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1619788213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 AUTUMN BREEZE WAY",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923806",
            "telephone_number": "786-452-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W STATE ROAD 434 STE 108",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504953",
            "telephone_number": "407-324-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAICEDO",
        "first_name": "SHANNON",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-387446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony L. Cabreira, M.D.
• Vanessa Jasmin Cabrera, M.A., CCC-SLP
• Sara ER Cacciatore, MS, CCC-SLP
• Yolanda Cadorette
• Jay Cage, BCABA
• Tamika Caines
• Chloe Calderon
• Jaime A Calderon, PSYCHOLOGIST
• Beverly Caldwell, L.M.T.
• Calm Relief, LLC (Calm Relief)

• Behavior Technician in Longwood, FL
• Providers in Longwood, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.

Verify at the official NPI Registry.