Provider Demographics
NPI:1861068074
Name:CALETZ, MADISON STONE (BCBA)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:STONE
Last Name:CALETZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4306 EVERGREEN LN STE 103
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3217
Mailing Address - Country:US
Mailing Address - Phone:703-828-5745
Mailing Address - Fax:703-738-7825
Practice Address - Street 1:617 N PAXTON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-2735
Practice Address - Country:US
Practice Address - Phone:703-828-5745
Practice Address - Fax:703-738-7825
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-23-67181103K00000X
0-21-12645106E00000X
VA17-43137106S00000X
VA0133003146103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician