Healthcare Provider Details

I. General information

NPI: 1174946529
Provider Name (Legal Business Name): EXCEL ABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2014
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 BAYVIEW DR
RICHMOND KY
40475-7511
US

IV. Provider business mailing address

116 BAYVIEW DR
RICHMOND KY
40475-7511
US

V. Phone/Fax

Practice location:
  • Phone: 859-248-0621
  • Fax: 859-957-1890
Mailing address:
  • Phone: 859-575-4442
  • Fax: 859-957-1890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0024
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LUNA MORIAH MIA WEISS-SALINAS
Title or Position: MEMBER
Credential:
Phone: 859-248-0621