Complete the Therapist Profile Intake Form Therapist BioFirst NameLast NamePsychology Today ProfileLicensure typeStates 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 OtherPrimary 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).EducationSubmit Form
