Provider Demographics
NPI:1942792924
Name:MORENO, LORINDA JEANNE ROY (BCBA)
Entity type:Individual
Prefix:
First Name:LORINDA
Middle Name:JEANNE ROY
Last Name:MORENO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 NUUANU AVE APT 3412
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4039
Mailing Address - Country:US
Mailing Address - Phone:808-482-7089
Mailing Address - Fax:
Practice Address - Street 1:1212 NUUANU AVE APT 3412
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4039
Practice Address - Country:US
Practice Address - Phone:239-235-0522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2025-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIBA-687103K00000X
FL1-21-52997103K00000X
HIMHC-1112101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health