Provider Demographics
NPI:1831794262
Name:CALECA, KYLE PHILLIP (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:PHILLIP
Last Name:CALECA
Suffix:
Gender:
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 E FRANKLIN BLVD APT D
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-4259
Mailing Address - Country:US
Mailing Address - Phone:980-421-2371
Mailing Address - Fax:
Practice Address - Street 1:900 COX RD STE C
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3433
Practice Address - Country:US
Practice Address - Phone:980-421-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1-23-70070103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst