Online Job Application

Job Application
Thank you for your interest in joining The Center for Conscious Alchemy. We collaborate with licensed providers, pre-licensed providers seeking independent licensure in the state of Minnesota dependent on specific licensure type, prescribers, and dedicated staff who share our commitment to compassionate, affirming, and high-quality care.

This application is used for both 1099 independent contractor opportunities (psychotherapy and psychiatric/medication management) and W-2 staff positions. Please complete the form below with your contact information, professional credentials, and relevant experience. Your responses help us verify licensing, insurance, and compliance requirements.

Note for psychotherapy and psychiatric applicants: This is not an employment application. Contractors are engaged on an independent basis and set their own schedules in collaboration with our team.
What is your name?*

First NameLast Name
What are your preferred pronouns?
What is your E-mail*
example@example.com
What is the best phone number to contact you?*
Format: (000) 000-0000.
What city do you live in?*
What state do you live in?*
What position are you applying for?*
What is your earliest possible start date?

MonthDayYear
Date
How did you hear about this position?
Cover letters are optional. If you’d like to share one, please paste it below.
Please do not exceed 200 words.
Please upload your resume*

Cancelof
Feel free to upload any other documents you'd like for us to review.

You can share certificates, diplomas etc.
Cancelof
Why do you want to work at The Center for Conscious Alchemy?
We're curious 😀

Psychotherapist
What type of Minnesota mental health license do you hold?*
What is your license number?*
Which Minnesota licensing board issued your license?*
What is your NPI number?
What is your CAQH ID?
Which therapeutic modalities or special trainings are you trained in or actively practicing?

EMDRIFS (Internal Family Systems)CBT (Cognitive Behavioral Therapy)DBT (Dialectical Behavior Therapy)Somatic ExperiencingTrauma-Informed CareMindfulness-Based (MBCT/MBSR)Other
In which states are you licensed to provide telehealth?*

Nurse Practitioner
What is your Minnesota RN license number?*
What is your Minnesota APRN license number?*
What is your APRN specialty certification?*
What national body issued your certification?*
What is your NPI number?*
Do you have e-prescribing credentials (EPCS)?*

YesNo
Are you currently registered with the Minnesota Prescription Monitoring Program (PMP)?*

YesNo
Have you completed 2,080 hours of post-licensure collaborative practice for full independent practice authority?*

YesNo
In which states are you licensed to provide telehealth?*

Are you legally authorized to work in the U.S.?*

YesNo
Will you now or in the future require visa sponsorship?*

YesNo
What is your preferred work location?*

On-site in St. PaulRemoteHybrid
Do you need a reasonable accommodation for this process?*

YesNo
What are your pay expectations?
Legal notices:

We’re an Equal Opportunity Employer. We consider qualified applicants without regard to race, color, creed, religion, national origin, sex, gender identity, sexual orientation, marital status, age, disability, familial status, or status with regard to public assistance, consistent with the Minnesota Human Rights Act. In Minneapolis, we also do not discriminate based on justice-impacted status (having a criminal record or history), height/weight, or housing status. If you need a reasonable accommodation to complete this application, contact info@consciousalchemy.co.

We do not ask about criminal history on this application. If applicable under Minnesota law, we may consider job-related criminal history after an interview or, if no interview is conducted, after a conditional offer.
Please provide your electronic signature to certify your responses are true and complete*
Should be Empty:

Job Application

Psychotherapist

Nurse Practitioner