Therapist Application

Full Name
Phone Number
Email
Are you fully licensed as an Ph.D, Psy.D, LCPC, LCSW-C, or LCMFT in the state of Maryland? *
Are you a licensed supervisor? *
What would you say is your preferred clinical orientation?
Please tell us about your specialty/niche(s).
List any certifications you have earned.
List your previous work experience.
Which population do you prefer to work with? (Choose all that apply) *
What is your availabilty? (Choose all that apply) *
Our clinicians are able to work independently and follow directions easily. Do you feel comfortable working independently and being able to follow through on scheduling your existing clients, taking copays or payment, keeping notes accurate and timely, responding to emails in a timely fashion, and staying organized? *
Requested hourly wage
Please give contact information for three professional references (Name, Address, Phone Number, and Email).

Please email a cover letter and resume to admin@holistichealingcounselingcenter.com