Ponte Vedra Behavioral Health LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

PONTE VEDRA BEHAVIORAL HEALTH LLC

Practice address

90 Fort Wade Rd Ste 100
Ponte Vedra, FL 32081-5114

Phone

(571) 398-1908

Fax

(386) 800-3358

NPI assigned

Feb 16, 2026

Organization subpart

No

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

Authorized official

Name

Mrs. Busayo Mary Enikanoselu Stelben, BCBANPI 1629548011

Title

Managing Member/Clinical Director

Phone

(571) 398-1908

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Busayo Mary Enikanoselu Stelben

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1629548011
  NPD Authorized official
• Lindsay Yudin

  • Behavior Technician
  • Ponte Vedra, FL
  • NPI 1083543243
  NPD (past)

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

{
    "created_epoch": "1771200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771200000000",
    "number": "1760335186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 CAIDEN DR",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320811101",
            "telephone_number": "571-398-1908",
            "fax_number": "386-800-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 FORT WADE RD STE 100",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815114",
            "telephone_number": "571-398-1908",
            "fax_number": "386-800-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONTE VEDRA BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-16",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A",
        "authorized_official_last_name": "STELBEN",
        "authorized_official_first_name": "BUSAYO",
        "authorized_official_middle_name": "MARY ENIKANOSELU",
        "authorized_official_title_or_position": "MANAGING MEMBER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "571-398-1908",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas D a Peterkin, M.D.
• Alexis Piarulli, D.C.
• Adam Podraza
• Sarah Poe, PT, DPT
• Ponte Vedra Beach Chiropractic Inc
• Ponte Vedra Complete Dentistry, PA
• Ponte Vedra Dental Group
• Ponte Vedra Hearing Associates, LLC
• Ponte Vedra Pediatric Dentistry and Orthodontics
• Ponte Vedra Speech Language and Learning LLC

• Behavior Analyst in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; 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.