Language
English (US)
Español
NC Spanish-Speaking Mental Health Provider List
Please note that only the fields with red stars are required.
Provider Name
*
First Name
Last Name
Email
*
example@example.com
Office Address (Optional)
Street Address
Street Address Line 2
City
County
Postal / Zip Code
Office Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Website
*
I have the following license in North Carolina:
*
Clinical Social Worker (LCSW/A)
Clinical Mental Health Counselor (LCMHC/A/S)
Marriage and Family Therapist (LMFT/A)
Clinical Addictions Specialist (LCAS/A)
Psychologist (PhD, PsyD, HSP, LPA)
Psychiatrist
North Carolina License #:
*
Clinical Specialties:
Modalities Used:
Population(s) Served:
Languages Spoken (other than English):
*
Do you offer in person and/or virtual sessions?
*
In Person
Virtual
Both
Please describe the financial structure for services (e.g. insurance accepted, sliding scale, pro bono, out of network, etc.)
*
Do you want to sign up for the La Mesita newsletter?
Yes
No
Are you interested in being contacted about any of the following opportunities?
Educational Activities for Community Organizations, Schools, etc.
Speaking Opportunities
Mental Health Trainings
Mentorship for Behavioral Health Students
Other
Submit
Should be Empty: