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Licensure information
*Do you have an interjurisdictional compact that allows you to practice teletherapy across state lines? If so, which one?
I do not have an interjurisdictional compact
PsyPACT
Social work licensure compact
Other
*Which state is your primary state of licensure
Select a State...
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
*What is your state licensure number
If you are licensed in any other state, list states and license numbers
Please add state (or abbreviation)ย and license number
What is your NPI (National Provider Identification) number? (If known)
What is your EIN (Employer Identification Number). If you have not set up an independent business, this would be your social security number
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