MEDICARE: ARISE THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	101YM0800X	Mental Health Counselor
4	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1326993569
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARISE THERAPY LLC

Provider Business Mailing Address
First Line	:	1110 N 7TH ST
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71291-4334
Country	:	US
Telephone Number	:	318-855-0111
Fax Number	:	318-855-0117

Provider Business Practice Location Address
First Line	:	1110 N 7TH ST
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71291-4334
Country	:	US
Telephone Number	:	318-855-0111
Fax Number	:	318-855-0117

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTIAN N GULLETTE
Credential	:
Telephone Number	:	318-855-0111

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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