Networker Website Therapist Registration

(The fee for a two year listing in the Networker Website is $50.00)


Name:



      


 
  
      Your address will not be listed.

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 $50 fee.





Years of
Experience





Examples of Practice/Specialty:
General Practice Areas-
Adolescent Assessments & Psychotherapy, Child & Adolescent Assessments & Psychotherapy, Conjoint Psychotherapy, Family & Conjoint Psychotherapy, General Adult Assessments & Psychotherapy, General Psychotherapy, Group Psychotherapy, Individual Adult Psychotherapy and Individual Psychotherapy.
Specialty Areas- Adult Survivors of Dysfunctional Families, Anxiety Disorders, Body-Mind Approaches, Career Counseling, 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 Assessments & Therapy, Eating Disorders, Gay, Lesbian & Gender 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)



Fee for Service:
(Optional)