Organization
MORENO THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE RAY MORENO LIMHP (THERAPIST)
(402) 660-9555
Entity
Organization
Contact information
Practice address
256 N 115TH ST STE 3, OMAHA, NE 68154-2558
(402) 660-9555
Mailing address
256 N 115TH ST STE 3, OMAHA, NE 68154-2558
(402) 660-9555
(402) 914-4815
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790238665
—
NE
Enumeration date
06/10/2020
Last updated
03/03/2026
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