Are you a licensed therapist or counselor that would like to be listed in the Online Therapist Directory? If so, fill out the form below (all required fields). After submitting your listing, your application will be reviewed and upon approval, we will include your profile and practice details in the directory.

* denotes a required field

Full Name*
E-Mail*
Business Name
Street
Suite
City*
State*
Zip
Phone
Website URL
Facebook Page URL
Gender*
Credentials*  CASAC   CET   LMFT   LPC 
 LCSW   NCC   LCMF   LISW 
 LMHT   LPC   LPHA   MA 
 MS   MSW   NCC   PhD 
 PsyD   Other: 
Specialties
Language(s)*  English   Spanish   French 
 Portuguese   German   Chinese 
 Other: 
Years Experience*
License Number
Profile Photo*

Profile/Biography* (750 words max, HTML not allowed)