Provider Demographics
NPI:1174946529
Name:EXCEL ABA, LLC
Entity type:Organization
Organization Name:EXCEL ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LUNA
Authorized Official - Middle Name:MORIAH MIA
Authorized Official - Last Name:WEISS-SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-248-0621
Mailing Address - Street 1:116 BAYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-7511
Mailing Address - Country:US
Mailing Address - Phone:859-248-0621
Mailing Address - Fax:859-957-1890
Practice Address - Street 1:116 BAYVIEW DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-7511
Practice Address - Country:US
Practice Address - Phone:859-248-0621
Practice Address - Fax:859-957-1890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-21
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
KY0024103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty