Networker Therapist Registration

There are three price ranges: Basic (up to five practice/specialty listings)- $100;
Premium (up to ten pracitce specialty listings)- $200 and Deluxe (10-15 practice/specialty listings)- $300


Name:



      


 
  
      
Your address will not be displayed in your listing.

Phone
Number:

 
Example: 734-761-8813
 

Agency Affiliation:
(Optional)






    Example:   Ph.D., Child Psychology, Michigan State University, 1993




    Examples:    Licensed Psychologist #6301007735, State of Michigan, 1995- Present
                         Member, Michigan Psychological Association, 1998- Present


     
You are allowed five listings for the basic $100 fee. Up to ten listings is $200 and ten to fifteen is $300.














Years of
Experience
















Examples of Practice/Specialty Listings:
General Practice Areas-
Adolescent Psychotherapy, Child & Adolescent Psychotherapy, Conjoint Psychotherapy, Family & Conjoint Psychotherapy, General Adult Psychotherapy, General Psychotherapy, Group Psychotherapy, Individual Adult Psychotherapy and Individual Psychotherapy.
Specialty Areas- Adult Survivors of Dysfunctional Families, Anxiety Disorders, Body-Mind Approaches, Chemical Dependency Treatment, Child Management & Parenting, Chronic Illness, Cognitive Therapy, Multi-Cultural Issues, Custody Evaluations, Depression, Disassociative Disorders, Divorce Issues, Domestic Violence, Dual Diagnosis, Early Childhood Therapy, Eating Disorders, LGBTQ Issues, Grief & Bereavement, Learning Disabilities, Men's Issues, Mid-Life Growth & Change, Parent & Family Education, Pastoral Counseling, Post Partum Depression, PTSD, Psychoanalysis, Psychopharmocology, School/Educational Psychology, Sexual Addictions, Sexual Dysfunction, Sexual & Physical Abuse, Survivors of Sexual Abuse, Solution Focused Brief Therapy, Supervision, Women's Issues, etc.


(Optional)


 
  
      
  
      
 
Sliding Fee Scale:
(Optional)

No Yes

Fee for Service:
(Optional)