PC List Application

counselor / therapist

listing application form

Name (as you would like it to appear on listing)

List all degrees and accreditationscertifications related to your counselortherapist training (list using proper abbreviations, such as "M.Div., MC, PhD, CPC, CCPT, LCPC, DOC-Endorsed, APC, etc.):

List primary City, and State or Province, in which your practice is located:

If you are proficient in more than English, list all languages in which you can practice therapy (example -- "fluent in Spanish and English"):

List any areas of focus and specialty, if you would like to include such in your listing (examples -- "depression, life transitions, LGBTQ+ issues, couples therapy, MBSR, Cognitive Behavioral Therapy, etc.):

Website or Webpage associated with your professional practice, if any, and if you would like such listed:

Professional Email contact address, associated with your professional practice, if you would like such listed:

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to return to main Counselors directory page.

Complete and submit the form below,

to request yourself to be listed on the counselor / therapist listing pages: