User account

Account information
Spaces are allowed; punctuation is not allowed except for periods, hyphens, and underscores.
A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.
Please re-type your e-mail address to confirm it is accurate.
Provide a password for the new account in both fields.
Personal

Your professional credentials (PhD, M.A., etc)

Would you be interested in being an NPI Mentor?

If you are a current NPI Board Member, your role on the board.

This email address will be visible to users on your profile, but is not required.

Would you like to receive a printed newsletter and directory, or a digital / email format?

The content of this field is kept private and will not be shown publicly.
Location
e.g. a place of business, venue, meeting point
Personal Mailing Address
The content of this field is kept private and will not be shown publicly.
The content of this field is kept private and will not be shown publicly.
The content of this field is kept private and will not be shown publicly.
The content of this field is kept private and will not be shown publicly.
The content of this field is kept private and will not be shown publicly.
Professional

Enter the URL of your Website here

Are you a current NPI Board Member

Check the primary populations you servce in your practice setting.

Check the specializations (diagnoses, presenting issues, problems, situations) for which you have special training and/or experience.

Check all languages in which you are fluent enough to conduct psychotherapy sessions. If a language is needed to be added, please contact us.

Check the insurance networks and provider panels in which you are a current in-network participant.

Please check the treatment modalities in which you have specific training and/or experience.

Check the Professional Associations to which you currently belong. If you belong to an association not currently on the list, you will have an opportunity to add it later.

Check the professional disciplines in which you are credentialed and/or trained.

Please list any other insurance networks or preffered panel providers on which you are an eligible in-network provider.

Check the forms of accessibility which your practice currently accomodates (under the Americans with Disiabilities Act, etc.)

Check the payment arrangements you participate in.

CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.