NPIMap

Organization Active NPI

Moreno Therapy P.C., LLC

  • Mental Health Counselor
  • Omaha, NE
National Provider Identifier
1609498609
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MORENO THERAPY P.C., LLC
Practice address
2620 N 132ND Ave
Omaha, NE 68164-4023
Phone
(402) 660-9555
NPI assigned
May 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Authorized official

Name
Dominique Ray Moreno, LIMHPNPI 1790238665
Title
Founder
Phone
(402) 660-9555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

2620 N 132ND Ave
Omaha, NE 68164-4023

Mailing address

2620 N 132ND Ave
Omaha, NE 68164-4023
Phone (402) 660-9555

Other identifiers 1

IdentifierTypeStateIssuer
1790238665MedicaidNE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dominiquemoreno@morenotherapy.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1609498609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 N 132ND AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681644023",
            "telephone_number": "402-660-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N 132ND AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681644023",
            "telephone_number": "402-660-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORENO THERAPY P.C., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-12",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "402-660-9555",
        "authorized_official_credential": "LIMHP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790238665",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dominiquemoreno@morenotherapy.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2620 N 132nd Ave",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681644023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.