Provider Demographics
NPI:1396469078
Name:ARISE THERAPY PLLC
Entity type:Organization
Organization Name:ARISE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC-A
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LOSHUN
Authorized Official - Last Name:MOON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:254-383-8499
Mailing Address - Street 1:30711 SHADY TRACE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-3878
Mailing Address - Country:US
Mailing Address - Phone:254-383-8499
Mailing Address - Fax:
Practice Address - Street 1:24624 INTERSTATE 45 N STE 200
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4084
Practice Address - Country:US
Practice Address - Phone:832-910-9817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder