Welcome to Collective Counseling Solutions!

If you have been approved as a therapist to be listed on the Collective Counseling Solutions website, please complete the form below. All questions in the form are required for us to build the most complete and appealing profile for you.

Once you have submitted your Therapist Profile Form, you will receive an email confirmation and we will review and approve your profile. From there, you will receive an Account Approved email and instructions on how you can log into your account to manage your profile(s).

New Therapist Profile Form

  • Please watch the short video before filling out your profile form or contacting us for support.
  • Please fill out ALL the fields below to submit your profile details.
  • Do not enter your profile in all CAPTIAL letters.
  • Do a grammar check on your bio before submitting your profile.
  • Please review the Therapist Support FAQs before contacting us for technical support.

Name(Required)
Enter your name and title as you wish it to appear on the website. (i.e. Nicholas Mancini, LMFT, LPC)
Emails are not published to the website. We use your email to create a user account for you to access the site.
Are you registering as an individual therapist profile or are you adding a therapist to your group practice?
ATTENTION: Please only choose "adding a therapist profile to a new or existing group practice" if you intend on having one account to manage all therapist profiles related to your group practice. If you want to be able to manage your own profile, then please choose "registering as an new individual therapist" and an individual user account will be created to manage this profile submission.

LOCATION DETAILS

Primary Address(Required)
Do you want your full address to be displayed?(Required)
(If not, only City, State, and Zip will be displayed)
Secondary Location Address
Do you want your full secondary address to be displayed?
(If not, only City, State, and Zip will be displayed)
What types of sessions are you available for?(Required)
Which States are you available for sessions?(Required)

BIO

This is your chance to tell visitors about yourself, your experience level, and your philosophy. Please write a few paragraphs of text to make this area shine on your profile. Make sure to proofread your profile.
The Primary Gender you want to show for searches. If you do not want a response here, select "No Answer."
The Primary Faith you want to show for searches. If you do not want a response here, select "No Answer."
The Primary Ethnicity you want to show for searches. If you do not want a response here, select "No Answer."
The Primary Sexuality you want to show for searches. If you do not want a response here, select "No Answer."

EDUCATION

Earned Degree or Education History(Required)
Please use the format of B.A. Psychology, University of Dayton. Insert one item per line by clicking on the + sign to the right of each field below.

SPECIALTY/INSURANCE

Primary Groups of Patients Seen(Required)
Check all that apply.
Client Demographics
Please select all client demographics you work with and would like displayed on your profile. (select all that apply)
Primary Areas of Specialty(Required)
Check ALL that apply, even if it seems that it is a duplicate. Don't worry, you can list out additional specialties below.
Additional Areas of Specialty
Please list out any additional areas of specialty. Insert one item per line by clicking on the + sign to the right of each field below.
What types of insurance do you accept?(Required)
Check all that apply.
Additional Types of Insurance Accepted
Please list out any additional types of insurance accepted. Insert one item per line by clicking on the + sign to the right of each field below.

PROFILE PHOTO

Please upload a high-quality photo that is at least 500x500 pixels in size. To update your profile photo, please first upload your new profile photo. Then, remove your current photo by selecting the X next to file name below.
Drop files here or
Accepted file types: jpg, png, Max. file size: 1 MB.
    Accepting Patients?
    If you select no, your profile will not appear in search results.