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First Name

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Website URL

Address

Suite Number

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Types of Therapy Offered

Online In-Person Online & In-Person

List Your Credentials

When did you start practicing?

License Type*

License State (Additional licenses can be added below)

License Number

License Expiration Date

Practicing Telepsychology Under PSYPACT

I have obtained the E. Passport and the Authority to Practice Telepsychology (APIT) from the PSYPACT Commission.

Age Group (Which age group(s) do you prefer to work with? Select all that apply.)

Adults (25-64) Children (5-12) Seniors (65+) Teen (13-17) Young adults (18-24) Young children (0-4)

Types of Service
(Which types of counseling services do you provide? Select all that apply.)

Individuals Marriages & Couples family & Groups Christians

Accepted payment methods

Areas of practise
(Select up to 5 options)

Specialties
(Select up to 10 options)

Treatment Approach

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Gender

Prefer Not to Say Male Female Non-binary Transgender

Race and Ethnic Background (Optional)

White or Caucasian Black & African American

Languages spoken

Spanish English Arabic French

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Cash
Aetna
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EAP:Evernorth
EAP:UnitedHealthcare/Optum
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OptumHealth Complex Medical Conditions
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Oxford
Surest (formerly Bind)
Tufts Health/Cigna
United Medical Resources
UnitedHealthcare Life Insurance
UnitedHealthcare Shared Services
UnitedHealthcare StudentResources
UnitedHealthcare/Optum

Anxiety
Depression
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Trauma and PTSD
Couples Counseling
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Life Transitions
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Child or Adolescent
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LGBTQ
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Post Partum
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Serious Mental Illness
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School Issues
Phobias
Older Adults
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Foster Care/Adoption
Military/Veterans

Accelerated Experiential Dynamic Psychotherapy (AEDP)
Acceptance and commitment (ACT)
Adlerian
Attachment-based
Biofeedback
Brainspotting
Child Parent Psychotherapy
Christian Counseling
Cognitive Behavior Therapy for Suicide Prevention (CBT-SP)
Cognitive Behavioral (CBT)
Cognitive Behavioral Therapy for Insomnia (CBT-i)
Cognitive Processing (CPT)
Collaborative Management and Assessment of Suicidality (CAMS)
Compassion Focused
Couples Counseling
Culturally Sensitive Therapy
Dialectical Behavior (DBT)
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Experiential Therapy
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Faith based therapy
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Mindfulness-Based Therapy
Motivational Interviewing
Multicultural
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Neuro-Linguistic Programming (NLP)
Neurofeedback
Parent-Child Interaction (PCIT)
Person-centered (Rogerian)
Play Therapy
Polyvagal Therapy
Positive Psychology
Prolonged Exposure Therapy
Psychoanalytic
Psychobiological Approach Couple Therapy
Psychodynamic
Psychoeducation
Racial trauma treatment
Rational Emotive Behavior Therapy
Reality Therapy
Relational
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Schema Therapy
Sex Therapy
Solution Focused Brief Treatment
Somatic
Strength-Based
Structural Family Therapy
Supportive
Transpersonal
Trauma Informed Care
Trauma-Focused CBT