Therapist Profile Intake Form - The Empowering Space, PLLC

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The Empowering Space, PLLC, online therapy Texas and Ohio virtual therapy clinic therapy for millennials evidence-based online therapy anxiety and depression counseling online

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Services
About Us
- Meet Our Therapists
- Meet Our MSW Interns
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Home
Services
About Us
- Meet Our Therapists
- Meet Our MSW Interns
FAQs
Resources
- Blog
- Resources
Pricing & Insurance
Contact Us

Intern-supervised therapy from $35 • Licensed therapists from $85 • Sliding scale available

Home
Services
About Us
- Meet Our Therapists
- Meet Our MSW Interns
FAQs
Resources
- Blog
- Resources
Pricing & Insurance
Contact Us

Home
Services
About Us
- Meet Our Therapists
- Meet Our MSW Interns
FAQs
Resources
- Blog
- Resources
Pricing & Insurance
Contact Us

Book Now

Complete the Therapist Profile Intake Form

Therapist Bio

First Name

Last Name

Psychology Today Profile

Licensure type

States licensed in (separate with commas if needed)

Focus Areas

Couples Therapy

Adult Individual Therapy

Child and Adolescent Therapy

Trauma

Anxiety

Burnout

Identity Development

Life Transitions

Grief

Crisis Support

LGBTQIA+

Addiction Recovery

Other

Primary Specialties (Top 3)

Approaches

CBT

Somatic

Client-Centered

Strengths-Based

Trauma-Informed

EMDR

Attachment-Based

Anything not listed?

Modalities & Services

Individual Therapy

Couples Therapy

Coaching

Children/Adolescent Therapy

Family Therapy

Text-Based Therapy

ESA Letters

Anything not listed?

Fees: Initial Assessment (Individual) - Individual Session - Initial Assessment (Couples) - Couples 60 min - Couples 90 min - Coaching - Sliding Scale Available? (Yes/No)

Briefly describe your experience working with clients (3–6 sentences).

Education

The Empowering Space, PLLC

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Contact

Premiere Online Therapy in Texas, Ohio.
214-775-0857
469-445-2101
info@theempoweringspace.com

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Here's what happens next

No commitment. No waitlist. Just a simple booking.

1

Pick a therapist and time slot Choose from available evening and weekend slots

2

Complete a short intake Takes about 5 minutes — your information is HIPAA-secure

3

We confirm within 24 hours You'll get an email with your session link and what to expect

HIPAA compliant

Cancel anytime

~5 min to book

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