Join Our Partner Community Today Mental health professionals – Therapists, mental health treatment centers, and counselors Tell us about your practice:First Name*Last Name*What is your role?*AdmissionsAftercareCBTCEODBTDirectorOutreachOwnerPsychiatristPsychologistTherapistPractice Name*Website Address*What is your primary contact typeChose OptionMobileOfficeContact Primary Phone NumberEmail*Street Address*Please type in the mailing address of your practiceCity*State*Alabama ALAlaska AKArizona AZArkansas ARCalifornia CAColorado COConnecticut CTDelaware DEFlorida FLGeorgia GAHawaii HIIdaho IDIllinois ILIowa IAKansas KSKentucky KYLouisiana LAMaine MEMaryland MDMassachusetts MAMichigan MIMinnesota MNMississippi MSMissouri MOMontana MTNebraska NENevada NVNew Hampshire NHNew Mexico NMNew York CityNew York NYNey Jersey NJNorth Carolina NCNorth Dakota NDOhio OHOklahoma OKOregon ORPennsylvania PARhode Island RISouth Carolina SCTennessee TNTexas TXUtah UTVermont VTVirginia VAWashington WAWest Virginia WVWisconsin WIWyoming WYZip*In what state(s) are you licensed to treat?Alabama ALAlaska AKArizona AZArkansas ARCalifornia CAColorado COConnecticut CTDelaware DEFlorida FLGeorgia GAHawaii HIIdaho IDIllinois ILIowa IAKansas KSKentucky KYLouisiana LAMaine MEMaryland MDMassachusetts MAMichigan MIMinnesota MNMississippi MSMissouri MOMontana MTNebraska NENevada NVNew Hampshire NHNew Mexico NMNew York NYNey Jersey NJNorth Carolina NCNorth Dakota NDOhio OHOklahoma OKOregon ORPennsylvania PARhode Island RISouth Carolina SCTennessee TNTexas TXUtah UTVermont VTVirginia VAWashington WAWest Virginia WVWisconsin WIWyoming WYWould you like to receive referrals?*YesNoHow would you like to receive them? Example: Email, website link, etcEmailWebsite LinkPhone CallIs your practice faith-based?*YesNoBothAre you affiliated with a specific denomination?*Assembly of GodBaptistCatholicChurch of GodChurch of NazareneEpiscopalLutheranMethodistN/ANondenominationalPresbyterianDo you treat adults?*MaleFemaleBothNoDo you treat young adults (18-25)*MaleFemaleBothNoDo you treat adolescents(13-17)?*MaleFemaleBothNoDo you treat children(under 13)?*MaleFemaleBothNoWhat forms of payment are accepted?AetnaAlliantAmeri GroupAmerican BehavioralBCBSBCBS-StateBeaconCignaHealth GramHumanaIn NetworkKaiserMagellanMedcostMedicaidMedicareOptumOut of NetworkSelf PaySliding ScaleState InsuranceSuperbillTricareUnited Health CareValue OptionsOther- Please describeN/ADo you speak any language other than English?*NoArabicChineseFrenchKoreanSpanishTagalog(Including Filipino)VietnameseDo you offer telehealth to residents of other states than your listed state of practice?Do you have any particular specialty areas?*Abuse VictimsAddiction: Sex/Porn AddictionAddiction/Substance AbuseADHDArt TherapyAutism SpectrumBi-PolarBorder-Line PersonalityCBTChild/Adolescent PsychiatryCodependencyDBTDepressionEating DisordersEMDRGrief/LossHypnotherapyInfertilityLife transitionsMarriage/FamilyNeurofeedbackNuerologyOCDODDOutpatientOutreachParentingPhobiasPlay TherapyPremaritalPTSDSchizophreniaSpiritual FormationTelehealthTMSTraumaVeteransHow did you hear about Honey Lake Clinic?AACCColleagueConferenceGoogleHoney Lake Contacted meIECADo you agree to receive future emails from HLC partner Community containing resources, upcoming event schedule, updates on HLC programs?Yes I agree to receive emails & referrals from HLCNo I disagree to receive emails & referrals from HLCΔ