Provider Demographics
NPI:1780051359
Name:KATALYST PSYCHOLOGICAL FAMILY CENTER
Entity type:Organization
Organization Name:KATALYST PSYCHOLOGICAL FAMILY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATERINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLSTIKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:603-213-0700
Mailing Address - Street 1:17 OLDE LANTERN RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4815
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:65 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1905
Practice Address - Country:US
Practice Address - Phone:603-213-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-30
Last Update Date:2015-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1284103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty