New Patient Portal TEST Patient Portal Provider*Search by provider name, practice name, or city.Start typing...Agha-Ball, Erum, LCSWA - Kids On Up Psychotherapy, Inc. - Chapel Hill, NCAlexander, Jennifer, PMNHP-BC - Whole Life Solutions, LLC - Peoria Heights, ILAmes, Gary, MA - Gary Ames, Licensed Psychologist - Bala Cynwyd, PAAnderson, Glenn, LMFT - Glenn Anderson, LMFT - Rocklin, CAAtkins, Abigail, Ed.D. - Abigail Atkins Ed.D. - Phoenix, AZBader, Christin, LMFT - Christin Bader, LMFT - Rocklin, CABaird, Amy, LCPC - Restored Counseling Inc. - Peoria, ILBaird, Scott, LCPC - Restored Counseling Inc. - Peoria, ILBarger, Meredith, LCPC - Inspirit Counseling Services, Inc. - Columbia, MDBassham, Kelly, LMSW - Center for Relationship & Sexual Health - Royal Oak, MIBaughman, Rosemary, LCSW - Courageous Hearts, LLC - Lincoln, DEBeatty, Darlene, LCSW - Catholic Charities Hawaii - Honolulu, HIBekker, Aida, LCSW - Riverview Psychological Services PC - Fishkill, NYBerardo, Doris, LCSW - Riverview Psychological Services PC - Fishkill, NYBerger, Jane, LCSW - Jane Berger, LCSW - Santa Fe, NMBiller, Sandra, LMFT - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTBirenbaum, Susan, LCSW - Susan Birenbaum, LCSW, MBA, C-ASWCM - New York, NYBliss, Crandell (Dell), LCPC - Bliss Counseling - Libertyville, ILBoyer, Jeffrey, LMSW - Psychotherapy & Counseling Services PC - Northville, MIBrieger, Julie, Ph.D., LPC - Wellspring of Life, LLC - Erie, PABrinkman, Christene, LPC-S, LCDC - Creative Counseling - Richardson, TXBroughton, Daniel, LPC - Daniel T Broughton, Inc - Ortonville, MIBrown, Caroline, LCSW - Riverview Psychological Services PC - Fishkill, NYBurks, Juliann, LMFT - Juliann R Burks, LMFT, PLLC - Johnson City, TNButler, Deborah, LPC - Deborah Butler, LPC - Johnson City, TNButler, Tracey, LCPC - Tracey Butler Counseling & Consulting Inc - Montgomery Vllg, MDByrnes, Laura, LCSWA - Kids On Up Psychotherapy, Inc. - Chapel Hill, NCCain, Juliet, LCSW - Inspirit Counseling Services, Inc. - Baltimore, MDCambron-Adams, Connie, LCSW - Cambron Talbott Counseling - Peoria, ILCamilli, Erika, LCAT - Riverview Psychological Services PC - Fishkill, NYCamilierri, Regina, LMFT - Treehouse Wisdom and Wellness, Inc. - Cortlandt Manor, NYCampagna, Anthony, Ph.D. - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTCarey, Mark, LPC - Kansas City Trauma and Wellness, LLC - Kansas City, MOCarr, Christine, LCSW - Healing Grace Ministries, Inc. - Lees Summit, MOChandross, Wendy, LCSW - Wendy Chandross, CISW, PC - Glendale, AZChurchill, Chiyo, LMFT - Catholic Charities Hawaii - Honolulu, HIClark, Rita, LMSW - Center for Relationship & Sexual Health - Royal Oak, MIClendenen-Moon, Dawn, LCSW - Healing Grace Ministries, Inc. - Lees Summit, MOCleary, Jackie, LPC, LMFT - Cleary Counseling and Consultation, Inc. - Tulsa, OKCoates, Kelly - LPC - Wellspring of Life, LLC - Erie, PACohn, Susan, LCSW - Susan Cohn, LCSW - Ardsley, NYCongdon, Diana, APRN - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTConner, Karen, LCSW - Inspirit Counseling Services, Inc. - Cockeysville, MDConnole, Kori, LMFT - Pathways Counseling, LLC - Las Cruces, NMCramer, Gill (Terry), LCSW - Cramercare - Brooklyn, NYCzarnecki, Cara, LCPC - Tabula Rasa, LLC - Aurora, ILDamond, Patrick, LPC - Wellspring of Life, LLC - Erie, PADavis, Jason, LCPC - Whole Life Solutions, LLC - Peoria Heights, ILDeCesare, Patrese, LCSW - Patricia DeCesare, LLC - Montgomery Vllg, MDDeeter, Michele, PLPC - Healing Grace Ministries, Inc. - Lees Summit, MODiLorenzo-Gomez, Kayla, LCSW - Riverview Psychological Services PC - Fishkill, NYDiPlacido, Mark, LPC - Wellspring of Life, LLC - Erie, PADougherty, Kevin, LCSW - Kevin Dougherty Counseling - Denver, CODowling, Sean, PLPC - Healing Grace Ministries, Inc. - Lees Summit, MODoyle, Jack, LCSW - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTDublinske, Amy, LPC - Healing Grace Ministries, Inc. - Lees Summit, MOEckerberg Helena Ph.D. - San Diego Psychotherapy Associates - San Diego, CAEpstein, David, Psy.D. - The Meridian Group of Chesterfield, LLC - Chesterfield, VAErichsen, Krystina, PLPC - Krystina Erichsen, LPC - Lees Summit, MOEsposito, Benita, LPC - The Esposito Institute, Inc. - Blairsville, GAEsteban, Bradley, LMHC - Catholic Charities Hawaii - Honolulu, HIEvans, Antoinette (Toni) - MA, LMFT - Transformative Counseing and Family Services - Normandy Park, WAFalconer, Shirley, LCSW - Riverview Psychological Services PC - Fishkill, NYFarley, Lauren, LPC - Lauren C Farley, LPC - Media, PAFeeny, Laura, LMSW - Center for Relationship & Sexual Health - Royal Oak, MIField, Ronald, Ph.D - Prism Psychological Services, PC - Cornelius, NCField, Ronald, Ph.D. - Riverview Psychological Services PC - Fishkill, NYFindlay, Melissa, LCSW - FamilyWork - Chesterfield, VAFisher, Jennifer , LCSW - Jennifer Fisher LCSW - Larchmont , NYFitzgerald, Lindsay, LCSW - Courageous Hearts, LLC - Lincoln, DEFleming, James, MD - Integrative Psychiatry - Lees Summit, MOFord, Terrie, RN MHCNS - Terrie M Ford RN MHCNS - Olympia, WAFowler, Christi, PC - Nicklaus Counseling Center, S.C. - Marinette, WIFowler, Heather, LPC - Before & After Counseling, LLC - Avis, PAFratzke, Eileen, LPC - Healing Grace Ministries, Inc. - Lees Summit, MOFrederick, Julie, LCPC - The Empowerment Group LLC - Kalispell, MTFritz, Nathan, LMHC - Harmonious Friends Counseling, PLLC - Normandy Park, WAGannon, Laura, LMSW - Treehouse Wisdom and Wellness, Inc. - Cortlandt Manor, NYGetter, Nancy, LCSW - Inspirit Counseling Services, Inc. - Cockeysville, MDGiesey, Eve, LPC-MHSP - Grace Pointe Counseling Center - Johnson City, TNGilmore, Alexa, LMSW - Inspirit Counseling Services, Inc. - Ruxton, MDGlanert, Christine, LCPC - Integrated Family Therapy of Illinois, PLLC - Morton, ILGlass, Lynessa, LMFT - Lynessa Glass, Inc. - Virginia Beach, VAGoforth, Denise, LCSW - Denise M. Goforth, LCSW - Peoria, ILGomez, Lisa, LPCC, LMHC - EAP of SNM LLC - Las Cruses, NMGottfried, Elana, LMSW - Center for Relationship & Sexual Health - Royal Oak, MIGrande, Caren, LCSW - Caren Grande, LCSW, LLC - Red Bank, NJGreene, Karen, LPC/LFMT - Crossings Counseling Center - Marietta, GAGrindstaff, Alicia, LPC - Healing Grace Ministries, Inc. - Lees Summit, MOGrosu, Victor, M.D. - Child Psych Services, LLC - Brick, NJHall, Emily, LCSW-C - Inspirit Counseling Services, Inc. - Nottingham, MDHalleron, Molly, LGPC - Inspirit Counseling Services, Inc. - Baltimore, MDHankins, Leroy, LCSW - Riverview Psychological Services PC - Fishkill, NYHansen, Dale, LMFT - Dale F. Hansen, Ph.D., D.Min., LMFT - Phoenix, AZHanson, Jean, Ph.D. - Hanson Psychological Services LLC - Danvers, MAHanson, Mark, Ph.D. - Hanson Psychological Services LLC - Danvers, MAHardin, Margaret, LCPC - Inspirit Counseling Services, Inc. - Ruxton, MDHarms, Lindsay, LCPC - Whole Life Solutions, LLC - Peoria Heights, ILHarrison, Sheryl, Ph.D. - Sheryl W. Harrison, Ph.D., LLC - Scottsdale, AZHaselhorst, Stacey, PLPC - Healing Grace Ministries, Inc. - Lees Summit, MOHeater, Rachel, LMFT - Treehouse Wisdom and Wellness, Inc. - Cortlandt Manor, NYHeineken, Tawnya, LPCC - Heineken Counseling, LLC - Las Cruces, NMHemmert, Elizabeth, LICSW - Elizabeth's Counseling - Normandy Park, WAHilgenkamp, Katy, LIMHP - Katy Hilgenkamp, LIMHP - Lincoln, NEHimes, Sarah, MA, LMHC - Sarah Himes Counseling - Normandy Park, WAHoffe, Lindsay, MA, LMFT - Lindsay Hoffe Counseling, LLC - Normandy Park, WAHolland, Julie, PLPC - Healing Grace Ministries, Inc. - Lees Summit, MOHolland, Shawn, LPC - Healing Grace Ministries, Inc. - Lees Summit, MOHolland, Tammy, LACMH - Courageous Hearts, LLC - Lincoln, DEHughes, Robert, Ph.D. HSP - NeuroBehavioral Associates, PLLC - Johnson City, TNHurley, Danette, MS, TLPC - Serenity Counseling & Mediation Center - Gallatin, TNJackson, Jill, LPC - Serenity Counseling & Meditation Center - Gallatin, TNJanke, Cynthia, LCSW - Serenity Counseling & Meditation Center - Gallatin, TNJohnson, Cynthia, LCSW - Riverview Psychological Services PC - Fishkill, NYJohnson, Cynthia, LCSW - Prism Psychological Services, PC - Cornelius, NCJonak, Nicole, SLP - Speech & Language Connections - Vancouver, WAJones, Jasmine, LCPC - Whole Life Solutions, LLC - Peoria Heights, ILJones, Sharmain, LCSW - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTKeller, Arnold, LMSW - Psychotherapy & Counseling Services PC - Northville, MIKiernan, Eliza, LPC-MHSP - J Eliza Kiernan, LPC-MHSP - Johnson City, TNKnox-Holub, Jodi, LCPC - Jodi Knox-Holub, LLC - Peoria, ILKobes, Solomon, LCSW - Kids On Up Psychotherapy, Inc. - Chapel Hill, NCKofender, Jill, Ph.D. - Jill L. Kofender Ph.D., PLLC - Waterford, MIKomm, Richard, Ed.D. - Phx Psychological Testing & Treatment - Phoenix, AZKorenblatt, Janice, LCSW - Janice Korenblatt, LCSW - Ardsley, NYKotzker, Leslie, LMSW - Riverview Psychological Services PC - Fishkill, NYKrikorian, Victoria, LMHC - Riverview Psychological Services PC - Fishkill, NYKroll, Marissa, MSW - Whole Life Solutions, LLC - Peoria Heights, ILKushner, Huri, LMSW - Psychotherapy & Counseling Services PC - Northville, MIKyle-Wolf, Lisa, LCSW - 7th Direction- Peoria, ILLang, Tim, Psy.D., ABPP - Southern Minnesota Psychological Services, PLLC - Albert Lea, MNLangley, Teresa (DeAnn), LPC-MHSP - Teresa DeAnn Langley, LPC, LLC - Buford, GALaRoche, Jennifer, LPC - Compass Behavioral Health - Erie, PALassen, Maureen, Ph.D. - Maureen K. Lassen, Ph.D., PC - Mesa, AZLawson, John, LMFT - John Lawson, LMFT - Johnson City, TNLeverette, Marquita, LCSW - A Balanced Life, LLC - Kansas City, MOLevy-Rubinstein, Diane, LMSW - Center for Relationship & Sexual Health - Royal Oak, MILewis-Bangura, Duni, LCSW - Riverview Psychological Services PC - Fishkill, NYLitinsky, Donna, LMSW - Center for Relationship & Sexual Health - Royal Oak, MILopez, Luz, MS - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTLoser, Steven, LPC - Whole Life Solutions, LLC - Peoria Heights, ILLott-Farmer, Lyndis, LMFT - Catholic Charities Hawaii - Hilo, HILove, Marissa, LPCC - Magnolia Counseling, LLC - Las Cruces, NMLudwig, Rosemarie, LPC/Ph.D. - Phoenix Psychological Services - Phoenix, AZLundgren, Susanne (Lily), LPC - Flying Heart Ranch, LLC - Phoenix, AZLungstrum, Cindy, LCSW - Trinity Life Counseling, LLC - Stark City, MOMagarian, Angela, LCSW - Angela Magarian Christian Counseling, LLC - Norman, OKMahon, Moira, MCCA - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTManela, Pamela, LMSW - Psychotherapy & Counseling Services PC - Northville, MIMancuso, Michele, LCSW - TruCare Counseling Services, LLC - Tinton Falls, NJMarshall, Nancy, LPCC - EAP of SNM LLC - Las Cruses, NMMcGrath, Teresa, LPC/LFMT - Teresa L McGrath, LPC, LMFT - The Woodlands, TXMcKee, LeeAnn, MA - Healing Grace Ministries, Inc. - Lees Summit, MOMcKinley, Marcia, LCPC - Marcia J. McKinley JD, PhD, LCPC - Germantown, MDMcKinney, Jane, LCSW - A Balanced Life, LLC - Kansas City, MOMcKnight, Chad, LCSW - Chad McKnight, LCSW - Colorado Springs, COMcLellan, Autumn, LPC - Autumn McLellan, LPC - Erie, PAMcManus, Sheila, Ph.D. - Dr. Sheila McManus, Ph.D. - Philadelphia, PAMcMillan, Mark, LMSW - Center for Relationship & Sexual Health - Royal Oak, MIMedis-Alvarado, Kymberly, LCSW - Courageous Hearts, LLC - Lincoln, DEMetzendorf, Beth, LCSW - Beth Metzendorf, LCSW - Larchmont, NYMichalczyk, John, LCPC - Inspirit Counseling Services, Inc. - Westminster, MDMiers, Carol, LPC/LFMT - Carol S. Miers Inc. - Houston, TXMiller, Alexandra, Psy.D. - Live Well Psychology Center, LLC - Sparta, NJMiller, Darcia, LMSW - Center for Relationship & Sexual Health - Royal Oak, MIMirkin, Lauren, LCPC, LDN - Lauren I Mirkin, LCPC, LDN - Lutherville, MDMount, David, Psy.D. - Mind Body Institute of the Piedmont PLLC - Winston-Salem, NCMunday, Michele, LPCMH - Courageous Hearts, LLC - Lincoln, DENeuzil, Georgeann, PMCNS - Innerpeace - Worthington, OHNevin, Alli, Psy.D. - Allison L Nevin, Psy.D., PLLC - Melbourne, FLNicklaus, Christine, LPC - Nicklaus Counseling Center, S.C. - Marinette, WINighswanger, Terry, LCPC - Whole Life Solutions, LLC - Peoria Heights, ILNordenberg, Liora, LCPC - Inspirit Counseling Services, Inc. - Baltimore, MDO'Connell, DonnaLee, MFT - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTOlivieri, Jamie, MFT - Treehouse Wisdom and Wellness, Inc. - Cortlandt Manor, NYPaine, Terry, LCSW - A Balanced Life, LLC - Kansas City, MOPal, Melee, Psy.D. - San Diego Psychotherapy Associates - San Diego, CAPavao, Maile, LCSW - Catholic Charities Hawaii - Hilo, HIPearson, Amber, LPC - Integrated Wellness and Strategies, LLC - Broomfield, COPearson, Kyle, LPC - Whole Life Solutions, LLC - Peoria Heights, ILPeck, Lisa, LMHC - Catholic Charities Hawaii - Honolulu, HIPeck, Melissa, LPC - Wellspring of Life, LLC - Erie, PAPerlman, Greg, LCSW - Treehouse Wisdom and Wellness, Inc. - Cortlandt Manor, NYPinnell, Cornelia, Ph.D. - Cornelia Maré Pinnell, Ph.D. - Glendale, AZPolk, Inobeme, LCSW - Riverview Psychological Services PC - Fishkill, NYPorter, Sylvia, LCPC - Whole Life Solutions, LLC - Peoria Heights, ILPowell, Jason, MFT - Transformative Counseling and Family Services, LLC - Normandy Park, WAPowell, John, Ph.D. - John Powell, Ph.D. - Rocklin, CAPowers, Joan, LMFT - Joan L. Powers, LMFT - Rocklin, CAPrymuszewski, Theresa, LCPC - Inspirit Counseling Services, Inc - Linthicum Heights, MDRamponi, Theresa, APRN - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTRibbens, Judith, LCPC - Nicklaus Counseling Center, S.C. - Marinette, WIRice, Jessica, LPC - Wellspring of Life, LLC - Erie, PARiggs, Catherine, LCSW - Tri-Cities Counseling Services, PLLC - Tazewell, VARinkenberger, Kristin, LCPC - Integrated Family Therapy of Illinois, PLLC - Morton, ILRiviello, Tom, LMHC - Tom Riviello Mental Health Counseling,PC - Sayville, NYRizk, Nadin, Psy.D. - Healing Grace Ministries, Inc. - Lees Summit, MORobbins, David, LPC - DP Robbins Psychology Resources LLC - Lees Summit, MORobbins, Kelli, LCSW - Riverview Psychological Services PC - Fishkill, NYRobbins-Thompson, Lane, LCSWA - Kids On Up Psychotherapy, Inc. - Chapel Hill, NCRobert, Elisabeth (Libby), LCSW - Elisabeth M. Robert, LICSW - New Bedford, MARoberts, Yehuda, LCSW - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTRobke, Dina, LCSW - Dina OShea Robke LCSW BCD - Arvada, CORomero, Rita, Ph.D. - San Diego Psychotherapy Associates - San Diego, CARoper, Bradley, LCSW - Brad Roper, LLC - Powell, WYRuma, Susan, LMSW - Center for Relationship & Sexual Health - Royal Oak, MIRuth, Lauri, LPC - Healing Grace Ministries, Inc. - Lees Summit, MOSabanska-Melillo, Kateryna, MFT - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTSalemme, Thomas, LCSW - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTSalvatore, Robert, LPC - Psychotherapy & Counseling Services PC - Northville, MISarma, Subbu, MD - Subbu J Sarma MD, LLC - Kansas City, MOScales, Sarah, LMSW - Center for Relationship & Sexual Health - Royal Oak, MISchellenberg, Paul, LCPC - Paul Schellenberg LLC - Peoria, ILSchilling, Elizabeth, Ph.D. - Riverview Psychological Services PC - Fishkill, NYSchulte, Rita, LPC - Rita A Schulte, LPC - Fairfax Station, VASchultz, Nikki, LMSW - Treehouse Wisdom and Wellness, Inc. - Cortlandt Manor, NYSciotto, Mary, Psy.D. - Mary C. Sciotto, Psy.D. - Chesterfield, VASchwab, Lisa, LCPC - Whole Life Solutions, LLC - Peoria Heights, ILServiss, Suzanne, LCSW - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTSexton-Newton, Jill, LPC - The Meridian Group of Chesterfield, LLC - Chesterfield, VAShaw, Rebecca, LCSW - Rebecca Shaw, LCSW - Las Cruces, NMSchieferle-Uhlenbrock, Allison, LCPC - Integrated Family Therapy of Illinois, PLLC - Morton, ILSiegel, Bobette, LCSW - Bobette Smith Siegel, MSW, LLC - Scottsdale, AZSigler, Stephanie, LPC - Cognitive Restoration, LLC - Harker Heights, TXSlater, Bonnie, LPC - Bonnie Slater, LPC - Scottsdale, AZSmith, Brooke, LMSW - Riverview Psychological Services PC - Fishkill, NYSmith, Peter, LCSW-C - Inspirit Counseling Services, Inc. - Baltimore, MDSolomon, Judith, Ph.D. - Greater New Haven Cnsling & Therapy Ctr - Hamden, CTSparrow, Nancy, LMSW - Nancy Sparrow, LMSW - Royal Oak, MISpittal, Lisa, LMSW - Riverview Psychological Services PC - Fishkill, NYStallworth, John, JD, Ph.D. - John Stallworth, JD, PhD - Austin, TXStarr, Mary, LPC - Healing Grace Ministries, Inc. - Lees Summit, MOSteinborn, Sharon, LMFT - Anxiety Treatment Center of the SW, PC - Las Cruces, NMStoffers, Lynn, LPC - Lynn Stoffers, LPC - Scottsdale, AZStoffle, Linda, LPC - Nicklaus Counseling Center, S.C. - Marinette, WIStrid, Elaine, Ph.D. - Healing Grace Ministries, Inc. - Lees Summit, MOStromsness, Marilyn, Ph.D. - Marilyn Stromsness, Ph.D. PC - Mesa, AZStudham, Mary, LCSW-C - Inspirit Counseling Services, Inc. - Severna Park, MDSurval, Miriam, LCSW - Riverview Psychological Services PC - Fishkill, NYSwartout, Ilyssa, Psy.D. - Growing Edges LLC - Glendale, AZTangeman, Troy, LPC - Transitions Counseling and Consulting, LLC - Phoenix, AZTapia, Crystal, LMSW - Pure Clarity Counseling, LLC - Las Cruces, NMTawata, Dawn, LCSW - Catholic Charities - Honolulu, HITerrazas, Joe, LPCC - Joe Terrazas Mental Health, Inc. - Las Cruces, NMTerron, Rochely, LPC/LMHC - HOPE Virtual Counseling & Therapy LLC - Homestead, FLTerry, Josette, MFT - Treehouse Wisdom and Wellness, Inc. - Cortlandt Manor, NYTitus, Jenny, APRN - Advanced Practice LLC - Worland, WYTopor, Jessica, LMFT - Center for Relationship & Sexual Health - Royal Oak, MITrukositz, Mary, LMHC - Mary Trukositz, LMHC - Tacoma, WATurco, Alexis, MSW - Courageous Hearts, LLC - Lincoln, DEUkleya, Rob, LPC/LCSW - Healing Grace Ministries, Inc. - Lees Summit, MOVanBenSchoten, Joan, LCSW - Wisdom Rising and Associates Intl. LLC - Greenwood Vllg, COVanderwalde, Heidi, LPC - Heidi Vanderwalde, LCPC - Derwood, MDVon Grabe, Jeanette, MA, LPC - Center for Relationship & Sexual Health - Royal Oak, MIWeinstein, Susan, LCSW - Susan Weinstein, LCSW - Denver, COWeldon, Melodie, LMHC - Riverview Psychological Services PC - Fishkill, NYWeller, Kelli, LPC - Center for Relationship & Sexual Health - Royal Oak, MIWest-Effland, Sarah, LCSW - Sarah West-Effland LCSW, LLC - Lees Summit, MOWilliams, Cynthia, LPC - Psychotherapy & Counseling Services PC - Northville, MIWitkowski, Kim, LCPC - Inspirit Counseling Services, Inc. - Baltimore, MDWolfe, Maddie, LPC - Whole Life Solutions, LLC - Peoria Heights, ILWool, Brittany, LPC - Live Well Psychology Center, LLC - Sparta, NJWright-Aguilar, Elena, LCSW-C - Elena Wright-Aguilar, LCSW-C - Germantown, MDWynn, Cynthia, LMHC, CASAC - Treehouse Wisdom and Wellness, Inc. - Cortlandt Manor, NYYoung, Margaret, LCSW, RPT - Creative Journeys Counseling, LLC - Denver, COZoellers, Jason, LPC - Healing Grace Ministries, Inc. - Lees Summit, MOZweig, Lea, Psy.D. - San Diego Psychotherapy Associates - San Diego, CAA TestZ Test Patient's NamePatient's Name*Please provide the patient's name exactly as it's printed on their health insurance card. First Middle Last Mailing AddressMailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Contact Email AddressContact Email Address* Phone ContactsPhone Number (Primary)*Phone Type (Primary)-MobileHomeWork / OtherPhone Number (Alternate 1)Phone Type (Alternate 1)-MobileHomeWork / OtherPhone Number (Alternate 2)Phone Type (Alternate 2)-MobileHomeWork / Other Patient's Date Of BirthPatient's Date of Birth*Please provide the patient's date of birth using the mm/dd/yyyy format. MM slash DD slash YYYY Patient's GenderPatient's Gender*Patient's gender as recognized by the insurance company. Male Female Insurance InformationPrimary Insurance InformationPrimary Insurance Company Name* Member ID Number* Group Number* Is the patient the subscriber (policyholder)?* Yes No Primary Insurance SubscriberSubscriber's Name* First Middle Last Please provide the patient's name exactly as it's printed on their health insurance card. 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Only JPG, JPEG, PNG, and PDF files accepted (maximum file size 5MB).Secondary Card Front:Accepted file types: jpg, jpeg, png, pdf, Max. file size: 5 MB.Accepted types jpg, jpeg, png, pdf (Max Size 5MB)Secondary Card Back:Accepted file types: jpg, jpeg, png, pdf, Max. file size: 5 MB.Accepted types jpg, jpeg, png, pdf (Max Size 5MB)The information submitted on this page is being captured by Accurate Medical Billing, Inc. (AMB), a practice-management company contracted by your provider for this express purpose. This data might be used for the verification of insurance eligibility and benefits. Any verification performed by AMB is not a guarantee of coverage until claims associated with the services rendered by your provider have been processed by the insurance company. Thank you. Privacy Policy Accurate Medical Billing, Inc has confidentiality agreements in place with our contracted providers. 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