Provider Demographics
NPI:1689381485
Name:CATALYST COLLECTIVE LLC
Entity Type:Organization
Organization Name:CATALYST COLLECTIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALLORY
Authorized Official - Middle Name:
Authorized Official - Last Name:REICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:856-297-1411
Mailing Address - Street 1:1040 KINGS HWY N STE 650
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1931
Mailing Address - Country:US
Mailing Address - Phone:856-297-1411
Mailing Address - Fax:
Practice Address - Street 1:1040 KINGS HWY N STE 650
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1931
Practice Address - Country:US
Practice Address - Phone:856-297-1411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty