Counseling Organizations Directory

COUNSELING ORGANIZATIONS DIRECTORY

Organization Information

Organization Name:

Organization Type and Identifiers

Entity Type: Non-profit For-profit School-based program Community health center Private practice Other

Services, Populations, and Access

Services Offered: Individual counseling Group counseling Family counseling Crisis intervention Telehealth services Substance use counseling School-based counseling/support Psychological assessment Case management Trauma‑informed care

Children (0–12) Adolescents (13–17) Adults (18–64) Older adults (65+) All ages

Licensure, Accreditation, and Credential Verification

By completing this directory entry the organization authorizes verification of licensure and accreditation status with appropriate licensing bodies and accrediting organizations and certifies that all provided credential information is current and accurate.

Fees, Insurance, and Accessibility

Insurance Accepted: Private insurance Medicaid Medicare Sliding scale / income-based fees Self-pay only

Referral, Emergency, and Communication Protocols

Consent to Listing and Data Use

The organization requests placement in the Counseling Organizations Directory for the purpose of referrals by schools, community agencies, and families. The organization acknowledges the following and indicates consent where applicable:

I consent to the publication of the organization name, contact information, services, and non-sensitive program details in the Directory. I consent to receive referral inquiries from educational institutions and school personnel. I consent to limited sharing of listing information with authorized partner organizations for referral coordination. I authorize verification of credential and license information with licensing boards and accrediting agencies as necessary for inclusion.

Representations, Warranties, and Limitations of Liability

By submitting this form and signing below, the authorized representative affirms under penalty of perjury that:

1. The information provided herein is true, accurate, and complete to the best of the representative's knowledge and will be updated promptly if any material changes occur.
2. The organization will notify the Directory operator within thirty (30) days of any suspension, revocation, material restriction, or lapse in licensure or accreditation.
3. The Directory provides referrals for informational purposes and inclusion does not constitute endorsement; the organization releases and holds harmless the Directory operator from claims arising from referrals or use of the Directory, except to the extent caused by willful misconduct or gross negligence of the Directory operator.
4. The organization consents to reasonable verification inquiries and to provide documentation upon request to substantiate qualifications and program descriptions.

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