Licensed Mental Health Therapist

New York, New York
Clinical Care – New York /
Contract /
Hybrid

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Additional Provider Information

  • What city and state do you currently reside in?
  • When did you graduate from your highest level of education? (xx/xx/xxxx)
  • What is your NPI number?
  • Do you have a Medicare number? If so, can you please provide it?
  • Do you require supervision? If so, please provide your anticipated licensure date (month, year)
  • What state(s) are you licensed in?
  • What theoretical orientations do you utilize?
  • What clinical interventions (not theoretical orientations) do you use for clients who are suffering from Major Depression? (example: a thought log)
  • What is your clientele focus? (Check all that apply)
  • Are you comfortable seeing clients who have active suicidal ideation?
  • Do you have clinical expertise in work with any of the following presenting concerns?
  • Besides English, what languages (if any) can you provide therapy in?
  • Tell us about your clinical work (i.e. specialties, populations, etc)