New – Find a Provider

Full Name and Credentials:

Gender:

Race:

Ethnicity:

Clinic/Hospital:

Secondary Clinic/Hospital:

Languages Spoken:

Non-English Language Fluency Verified:

Degree:

Type of Provider:

Secondary Type of Provider:

Specialty:

Secondary Specialty:

Ages Served:

Areas of Expertise:

Session Types Available:

Types of Therapy Available:

Street Address:

City:

State:

Zip Code:

County:

Phone:

Secondary Street Address:

Secondary City:

Secondary State:

Secondary Zip Code:

Secondary County:

Secondary Phone:

Website:

Accepting New Patients:

Certified Interpreter Services Available, Including ASL:

Facility is ADA Accessible and has Accommodations for People with Physical Disabilities:

Completed Cultural Competency Training:

Additional Cultural and Linguistic Capabilities:

Offers Telehealth Appointments:

Auxiliary Aids Available:

Does the facility have an accessible route from site arrival points and an accessible entrance provided to everyone?:

Does the layout of the building allow people with different abilities to obtain services and participate in activities without assistance?:

Does the equipment being used and services utilized provide for all patients to be treated and equitably?:

Are facility practices reviewed for TIC and CLAS best practices?:

Please use the space below to list any additional auxiliary aids your facility may have available for Hearing Impaired Members?:

Any additional auxiliary aids your facility may have available for Vision Impaired Members: