Please update your contact information

Your partnership is important to us. To ensure we stay connected as we head into the new year, please take a moment to update us on any changes to your contact information.

First Name

Last Name

Title - press CTRL to select multiple Admissions Case Worker/Manager Chief (ex. CEO, CFO) Clinical Director Counselor Dietician Ed Consultant Executive Director Interventionist Lawyer Medical Director Non-Psych Physicans Nurse Nurse Practitioner Office Manager Outreach Parole Officer PCP Physicians Assistant President Principal Psychiatrist Psychologist School Counselor Social Worker Teacher Therapist

Credentials - press CTRL to select multiple APNP APSW BS BSW CADC CAPSW CEDS CSAC CSW DO DrPH LCPC LCSW LMFT LMHC LP LPC LPN LSW MA MBA MD MFT MHA MPH MS MSA MSW NP PA PhD PsyD RD RN SAC

Company

Street

City

State/Province AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip

Phone

Email

Insurance Accepted - press CTRL to select multipleAetna Anthem/BCBS APS Healthcare Associates for Healthcare Badger Care Beech Street Behavioral Health Network CCN Network Children's Community Health Plan Cigna Compsych Dean Employee Resource Center First Health GEHA Group Health Cooperative Health Care Network Health EOS Health Partners HFN Humana LifeSynch Magellan Behavioral Health Services Medicaid/T-19 Medical College of Wisconsin Medicare/T-18 Mercy Care Insurance MMSI- Mayo Health Company Multiplan National Provider Network NEAS Network Health Plan New Directions/BCBS Partners in Behavioral Health Physicians Plus Preferred Mental Health Management Private HealthCare Systems Security Health Plan Sliding Scale The Alliance UHC/UBH Uninsured United Behavioral Health United Health Care United Payors and United Providers Unity Health Plan USA Managed Care Value Options WEA WPPN WPS Other

Treatment Areas - press CTRL to select multipleAddictions Anxiety Behavioral ED General MH/Other Mood OCD Personality PTSD

Treatment Specialties - press CTRL to select multipleADD/ADHD Agoraphobia Alcohol Anorexia Antisocial ARFID Attachment/Bonding Autism Binge Eating Bipolar Disorder Body Dysmorphic Borderline Bulimia Cannabis Conduct Disorder Cyclothymia Depression DID Dual Diagnosis Dysthymia EDNOS GAD Gambling Grief Hallucinogen Histrionic Hoarding Hypochondriasis LGBT Marriage and Family Narcissistic Narcotics OCD Opiates Panic Disorder Paranoia Phobias PICA Psychosis PTSD Risk Taking Rumination SAD Schizoid Schizophrenia Schizotypal Scrupulocity Selective Mutism Self-Injury Separation Anxiety Sexual Skin Picking Social Anxiety Stimulant Suicidal Ideation Tourettes Trauma Trichotillomania Withdrawal Management

Age Group Focus - press CTRL to select multiple Early Childhood Adolescents Young Adults Adult Older Adults Female Only Male Only