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Username
*
Spaces are allowed; punctuation is not allowed except for periods, hyphens, apostrophes, and underscores.
E-mail address
*
A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.
Is this for an Individual or Group Practice?
*
individual
group
Basic Information
The Information that you provide in this section will be used to set up the basic elements of your profile, including information on how you would like your profile to be presented to visitors and where you would like your information to be stored on our servers. If you would like to see an example of how a filled out profile looks like, you can view the example profile set up for you
here
.
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Your Name
Your Full Name
*
Please enter your name as you would like it to be displayed throughout this site. This can be different from your full name. This will be used every time your name is displayed to our visitors, such as in our search results and as the title of your profile page.
For example:
John Smith, Ph.D
Professional Category
Professional Category
*
Art Therapist
Clinical Social Worker
Drug and Alcohol Therapist
Licensed Professional Counselor
Licensed Psychoanalyst
Limited License Psychologist
Marriage and Family Therapist
Pastoral Counselor
Pre-licensed Professional
Professional Counselor
Psychiatric Nurse
Psychiatrist
Psychologist
School Counselor
Please choose your profession(s) from the list above.
Photo
Upload Your Photo
You may upload a photo to display on your profile as well as in our search results. The same photo will be used every time your profile is shown to one of our visitors. If you choose not to upload a photo of yourself, a default "No Image Available" photo will be displayed instead.
Files must be less than
1 MB
.
Allowed file types:
png gif jpg jpeg
.
Images must be smaller than
600x400
pixels.
Your Website
Your Website Address
URL
Enter the full link URL address to your official website, if you have one. Don't forget to include the
http://
. If you do not have a web site, you may leave this area blank.
About Your Practice
Introduce Yourself
*
You may use this area to provide our visitors with a short introduction about you and your practice. A good introduction should be between 75 and 200 words.
Choose Your Profile Address
Choose your URL: http://www.therapistdirect.info/therapists/
*
For example:
john-smith
A URL is a Universal Resource Locator that tells every web browser and server in the world exactly where to find your page. Enter the address that you would like our servers to store as your URL address.
The best URLs are set up with easy-to-remember names and words, such as your first and last name. Words should be separated by a hyphen ( - ) rather than a space or underscore ( _ ). This is so search engines will be able to recognize the names as being separate words.
For example, if you enter the URL as johnsmith or as john_smith, search engines will only recognize this phrase as one word - johnsmith and will not include it in results when someone searches for "John Smith"
. Please also be sure to use all lowercase letters when choosing your URL.
We will honor your choice of URL to the best of our abilities; however, we reserve the right to change your URL should the address you choose include anything that is in violation of our terms of service, can lead to penalties from search engines and other online tools, or if the URL you've chosen is already taken by someone else.
Once you have chosen a URL, you cannot change it later. If you find that you need to change your URL because of unforeseen circumstances (such as your name has changed or you misspelled a word) you may contact us and we will make the change for you.
Contact Information
This section will help to set up your contact information to be displayed on your Therapist Direct profile. The information that you provide here will be displayed on your profile and viewed by visitors. Any information that you do not wish to have publicly displayed should be left blank.
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Phone Numbers
Please enter any phone number(s) that visitors can use to contact you. Please remember to include the area code.
For Example:
(999) 999-9999
Phone
*
Please type in the
primary
phone number that visitors can use to contact you, including the area code.
For Example:
(999) 999-9999
Additional Phone
If you have a second phone number that you would like to include, you may enter it here. This can be another office number, home phone number, or cell hone number. Remember, this phone number will be displayed to the public, so please
do not
list a phone number that you do not wish to be shared. Please remember to include the area code.
For Example:
(999) 999 - 9999
Fax
Please enter your complete fax number, including the area code. If you prefer not to have a fax number displayed on your profile, you may leave this field blank.
For Example:
(999) 999 - 9999
Email
Email
*
Please enter the email address that you check most often. We will not display or give your email address to other people and will never sell or rent your email address to a third party; however this is the email address that people will send their information to via our forms should they elect to contact you through our site.
Office Hours
Hours of Operation
Practices and Specialties
You can use this area to share detailed information about your practice and your specialties. The information that you provide here will be shown on your profile page and will be indexed within our search engines to help interested visitors find you.
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Top Specialties
Please don't choose more than 3 specialties that you have the most experience with and make sure you do not enter the same specialties in the Practice Specialties section
Top Specialties
*
Addictions
ADHD
Adjustment Disorder
Adoption Issues
Adolescent Issues
Adult Children of Alcoholics
Alcoholism
Alzheimer's Disease
Anxiety Disorders
Asperger's Disorder
Autism
Bipolar Disorder
Body Dysmorphic Disorder
Brain Injury
Chronic Pain
Child Abuse
Co-dependency
Cognitive Disorders
Communication Disorders
Conduct Disorder
Crisis/Trauma
Depression
Dissociative Disorders
Divorce
Domestic Abuse
Dually Diagnosed Individuals
Eating Disorders
Ethnic/Cultural Issues
Gay/Lesbian Issues
Gender Identity
Grief/Loss
HIV/AIDS-related Issues
Impaired Professionals
Impulse Control Disorders
Infertility Issues
Infidelity
Learning Disabilities
Life Transitions
Men's Issues
OCD (Obsessive Compulsive Disorder)
Oppositional Defiant Disorder
Pain Management
Parenting Issues
Personal Growth
Personality Disorders
Physical Disabilities
PTSD (Post Traumatic Disorder)
Relationship Issues
Schizophrenia
Self-esteem
Sexual Abuse
Sexual Dysfunction
Sleep Disorders
Smoking Cessation
Somatoform Disorders
Spirituality
Stress Management
Substance Abuse
Terminal/Chronic Illness
Tourette's Disorder
Women's Issues
Other Top Specialties
Other Top Specialty
Other Top Specialty
Other Top Specialty
Practice Specialties
Practice Specialties
*
Addictions
ADHD
Adjustment Disorder
Adoption Issues
Adolescent Issues
Adult Children of Alcoholics
Alcoholism
Alzheimer's Disease
Anxiety Disorders
Asperger's Disorder
Autism
Bipolar Disorder
Body Dysmorphic Disorder
Brain Injury
Chronic Pain
Child Abuse
Co-dependency
Cognitive Disorders
Communication Disorders
Conduct Disorder
Crisis/Trauma
Depression
Dissociative Disorders
Divorce
Domestic Abuse
Dually Diagnosed Individuals
Eating Disorders
Ethnic/Cultural Issues
Gay/Lesbian Issues
Gender Identity
Grief/Loss
HIV/AIDS-related Issues
Impaired Professionals
Impulse Control Disorders
Infertility Issues
Infidelity
Learning Disabilities
Life Transitions
Men's Issues
OCD (Obsessive Compulsive Disorder)
Oppositional Defiant Disorder
Pain Management
Parenting Issues
Personal Growth
Personality Disorders
Physical Disabilities
PTSD (Posttraumatic Stress Disorder)
Relationship Issues
Schizophrenia
Self-esteem
Sexual Abuse
Sexual Dysfunction
Sleep Disorders
Smoking Cessation
Somatoform Disorders
Spirituality
Stress Management
Substance Abuse
Terminal/Chronic Illness
Tourette's Disorder
Women's Issues
Please don't choose more than 10 specialties and make sure you do not enter the same specialties that you did in the Top Specialties section.
Other Specialties
Other Specialty
Other Specialty
Other Specialty
Age Specialties
Age Specialty
Children
Adolescents
Adults
Elders
Demographics Specialties
Demographic Specialty
Any
African American
Asian American
Buddhist
Christian
Gay/Lesbian/Bisexual/Transgender
Hindu
Jewish
Latino American
Latter-day Saints/Mormon
Middle Eastern
Military/Veterans
Muslim
Native American
Pacific Islander
People with Disabilities
Women/Feminist
Other Demographic Specialties
Other Demographic
Other Demographic
Other Demographic
Languages Spoken
Languages Spoken
American Sign Language
Arabic
Bosnian
Cantonese
Catalan
Chinese
Croatian
Czech
Dutch
English
Farsi
French
German
Greek
Hebrew
Hindi
Hungarian
Italian
Japanese
Korean
Malayalam
Mandarin
Norwegian
Polish
Portuguese
Punjabi
Romanian
Russian
Serbian
Slovak
Spanish
Swahili
Swedish
Tagalog
Taiwanese
Turkish
Ukrainian
Vietnamese
Yiddish
Other Languages
Other Language
Other Language
Other Language
Locations
Location #
1
Location name
e.g. a place of business, venue, meeting point
Street
Additional
City
*
State/Province
*
Select
NOT LISTED
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
Virgin Islands
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Postal code
*
Location #
2
Location name
e.g. a place of business, venue, meeting point
Street
Additional
City
State/Province
Select
NOT LISTED
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
Virgin Islands
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Postal code
Location #
3
Location name
e.g. a place of business, venue, meeting point
Street
Additional
City
State/Province
Select
NOT LISTED
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
Virgin Islands
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Postal code
Client Services
Please describe the services you provide to your clients.
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Services Provided
Services Provided
Career Evaluations and Counseling
Coaching
Consultation Services to Employers
Court Ordered Evaluations
Critical Incident Stress Debriefing
Employee Assistance Counseling
Fitness for Duty Evaluations
Forensic Evaluations
Mediation
Medication Evaluations
Medication Management
Neuropsychiatry
Neuropsychological Testing
Psychiatric Evaluations
Psychoeducational Evaluations
Psychological Evaluations
Psychological Testing
Psychotherapy/Counseling
Return to Work Conference
Worker's Compensation Evaluations
Other Services Provided
Other Service
Other Service
Other Service
Session Format
Session Format
Individual
Couples
Family
Group
Treatment Approach
Treatment Approach
Adlerian
Art Therapy
Behavioral
Bioenergetic Analysis
Biofeedback/Neurofeedback
Biopsychosocial
Christian
Cognitive/Cognitive-Behavioral
Control Mastery
Dance/Movement Therapy
Developmental
Dialectical Behavior Therapy
Eclectic
EMDR
Existential/Humanistic
Experiential
Family Systems
Feminist
Gestalt
Hypnotherapy
Integrative
Intersubjective
Jungian
Light Therapy
Multicultural
Music Therapy
Narrative
Neuropsychology
Object Relations
Person-Centered
Play Therapy
Psychoanalytic
Psychodrama
Psychodynamic
Psychoeducational
Psychosocial
Rational-Emotive
Reality
Sandplay
Self Psychology
Social Constructionist
Social Learning
Solution-Focused Brief Therapy
Somatic
Transactional Analysis
Transpersonal
Other Treatment Approaches
Other Approach
Other Approach
Other Approach
Medication Use and Prescription
Prescribe Medication
- None -
Yes
No
Accepting New Clients
Accepting New Clients
- None -
Yes
No
Credentials
Affiliations and Credentials
Please describe your credentials, affiliations and education/training.
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Years in Practice
Years in Practice
years
Educational Background
Primary Degree
School Name
Degree
Year Received
Additional Degree
School Name
Degree
Year Received
Licensing Information
License Number
License State
- None -
ALABAMA (AL)
ALASKA (AK)
AMERICAN SAMOA (AS)
ARIZONA (AZ)
ARKANSAS (AR)
CALIFORNIA (CA)
COLORADO (CO)
CONNECTICUT (CT)
DELAWARE (DE)
DISTRICT OF COLUMBIA (DC)
FEDERATED STATES OF MICRONESIA (FM)
FLORIDA (FL)
GEORGIA (GA)
GUAM (GU)
HAWAII (HI)
IDAHO (ID)
ILLINOIS (IL)
INDIANA (IN)
IOWA (IA)
KANSAS (KS)
KENTUCKY (KY)
LOUISIANA (LA)
MAINE (ME)
MARSHALL ISLANDS (MH)
MARYLAND (MD)
MASSACHUSETTS (MA)
MICHIGAN (MI)
MINNESOTA (MN)
MISSISSIPPI (MS)
MISSOURI (MO)
MONTANA (MT)
NEBRASKA (NE)
NEVADA (NV)
NEW HAMPSHIRE (NH)
NEW JERSEY (NJ)
NEW MEXICO (NM)
NEW YORK (NY)
NORTH CAROLINA (NC)
NORTH DAKOTA (ND)
NORTHERN MARIANA ISLANDS (MP)
OHIO (OH)
OKLAHOMA (OK)
OREGON (OR)
PALAU (PW)
PENNSYLVANIA (PA)
PUERTO RICO (PR)
RHODE ISLAND (RI)
SOUTH CAROLINA (SC)
SOUTH DAKOTA (SD)
TENNESSEE (TN)
TEXAS (TX)
UTAH (UT)
VERMONT (VT)
VIRGIN ISLANDS (VI)
VIRGINIA (VA)
WASHINGTON (WA)
WEST VIRGINIA (WV)
WISCONSIN (WI)
WYOMING (WY)
Supervisory Licensure
Required if you are non-licensed and working under the license of a licensed therapist.
Supervisor's License Number
Board Certification
Complete if you are a physician
Board Certification
Additional Licenses / Certifications
Additional Licenses and Certifications
Order
Weight for row 1
-4
-3
-2
-1
0
1
2
3
4
Weight for row 2
-4
-3
-2
-1
0
1
2
3
4
Weight for row 3
-4
-3
-2
-1
0
1
2
3
4
Weight for row 4
-4
-3
-2
-1
0
1
2
3
4
Weight for row 5
-4
-3
-2
-1
0
1
2
3
4
Financial Information
Please describe payment options and which insurances you may take in your practice.
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Average Cost (per Session)
Average Cost (Per Session)
- None -
Less than $50
$50
$55
$60
$65
$70
$75
$80
$85
$90
$95
$100
$105
$110
$115
$120
$125
$130
$135
$140
$145
$150
$155
$160
$165
$170
$175
$180
$185
$190
$200
$205
$210
$215
$220
$225
$230
$235
$240
$245
$250
$255
$260
$265
$270
$275
$280
$285
$290
$295
$300
$305
$310
$315
$320
$325
$330
$335
$340
$345
$350
$355
$360
$365
$370
$375
$380
$385
$390
$395
$400
More than $400
Accepts Credit Cards
Accepts Credit Cards
- None -
Yes
No
Sliding Fee Scale
Sliding Fee Scale
- None -
Yes
No
Insurance Accepted
Insurance Accepted
Any Indemnity Plan
Any PPO
Aetna
AmeriHealth
Anthem
APS Healthcare
Beech Street
Blue Cross
Blue Shield
Care Choices
CareFirst
CCN
CIGNA
CompCare
ComPsych
CORPHEALTH
Empire
First Choice Health
GHI
Harvard Pilgrim
Health Net
HealthSmart
HIP
Holman Group
Horizon
Humana
Independence Blue Cross Interplan
Kaiser Permanente
Magellan
Managed Health Network (MHN)
Medi-Cal
Medicaid
Medicare
Mental Health Network
Military OneSource
MultiPlan
MVP
New Directions Behavioral Health
Oxford
PacifiCare
Physicians Plus
POMCO
Preferred Care
Preferred Health Network
Private Healthcare Systems (PHCS)
TRICARE
Trigon
Tufts Health Plan
UNICARE
United Behavioral Health (UBH)
UnitedHealthcare
ValueOptions
WellCare
Wellpoint
Other Insurance
If you accept any other type of insurance that is not already listed above, you may add it here. Please do not repeat the name of any insurance that is already listed above. Be sure to add only one additional insurance type per field.
Other Insurance
Other Insurance
Other Insurance
Fee Schedule
Fee Schedule
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Practice Specialties
Miscellaneous Information
Please use this area to provide any other miscellaneous information that you feel might be important to some of our visitors. The more details and information you provide about yourself, your practice and your offices, the easier it will be for our visitors searching for therapists to find you.
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Therapist's Gender
Therapist's Gender
- None -
Male
Female
Transportation
Near Public Transportation
- None -
Yes
No
Wheelchair Accessible
Wheelchair Accessible
- None -
Yes
No
Additional Comments
Enter Any Other Information You'd like to Include
