Provider Demographics
NPI:1427629617
Name:MORENO, JOYCE ARLINE (LMHC)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:ARLINE
Last Name:MORENO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28118
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-8118
Mailing Address - Country:US
Mailing Address - Phone:909-451-1535
Mailing Address - Fax:
Practice Address - Street 1:7100 FORT DENT WAY STE 220
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-8553
Practice Address - Country:US
Practice Address - Phone:909-451-1535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61167622101YM0800X
WALH61439573101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health