Intake or Consult Appointment Request With Nikia Dennis at Practical Online Therapy

1

Nikia Dennis is available Tues-Thurs Evenings, virtually, for clients in NY & NJ.Click the right arrow below to continue.

2

State where most virtual sessions will be attended from* This field is required.Our therapists are licensed in NY & NJ only, so they can only see clients virtually in one of those states.

New York

New Jersey

3

Payment Type (Insurance or Private Pay)* This field is required.

Aetna Insurance (In-Network)

Meritain Insurance (In-Network)

First Health (Not Healthfirst) Insurance (In-Network)

Private Pay/ No Insurance/ Out-of-Network

4

Intake or Consult?* This field is required.

I would like to get started right away: I'd like an intake.

I would like to take my time and interview the therapist first: I'd like a 20 minute video consult.

5

Session Type* This field is required.

Individual

Couples

Family

6

Days and times you're available* This field is required.

7

Book a 20 Minute Consultation with Nikia

8

Book a 45 Minute Intake with Nikia

9

Book a 60 Minute Intake with Nikia

10

Brief description of your reason for starting therapy at this time* This field is required.

11

Full Name* This field is required.

First Name

Last Name

12

Other Adult Participant's Name

First Name

Last Name

13

Contact Number* This field is required.

Please enter a valid phone number.

14

Email Address* This field is required.

example@example.com

15

Other Adult Participant’s Email Address* This field is required.

example@example.com