Licensed Counselors

Are you a licensed therapist practicing in New Jersey? If you are interested in joining a community committed to transforming lives and promoting mental wellness, we want to hear from you. Please fill out the form below so we can explore potential collaboration.

Registration Information

First Name

Last Name

Phone

Email

Confirm Email

Specialties

Please select all that apply:

Substance Abuse/AddictionsMental HealthMarriage CounselingFamily CounselingRehabilitation - Disabilities, Trauma etc.PsychotherapyPlay Therapy

Other?

Do you operate your own practice?

Please select... Yes No

Will the session be

Please select... In person tele-health Both

If yes, do you participate in any of the following?

MedicareMedicaidPrivate Insurance

What type of private insurance do you accept?

Are you willing to provide free counseling services to the community?

Please select... Yes No

Resume/Certificate

Please upload a resume or a certificate