First Name *

Last Name *

Email *

Phone *

Age *

Preferred Therapist(s) *

Any available therapist
Vishal Narang, LGPC
Audrey Schreiber, LMSW
Noah Hughes-Dunn, LGSW (they/them)
Khalilah Rasheed, LMSW
Renee Wang, LMSW
Brandon Brumskill, LCPC
Hannah Bricker, LMSW
Nicole Ziesing, LMSW
Mackenzie Speir Carter, LMSW
Katie Kaufmann
Lincoln Pratt, LMSW
Anna Ehrlich, LMSW
Casi Leisure, LGPC, (they/them)
Priscilla Martins Lamptey, LCPC
Hannah Davis, LMSW, LGSW
Sania Tildon, LMSW, (she/her)
Stephen Mann, LCPC, (he/him)
Jessica Jenkins, LCSW-C, LGSW
Mark Hollingshead, LGCP
Kimberley Ince, LGPC
Janet Svirsky, LMSW, LGSW
Chelsea Turner, LCSW-C, LCISW, (she/her/hers)
Alex Phelan, C-IAYT, E-RYT 500
Lisa Ghali, LCSW-C, LICSW
Sheila Ervin, LCSW-C, LICSW (she/her/hers)
Tanisha Sanders, LCSW-C
Simone Jacobs, LCSW-C, LICSW (she/her/hers)
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Phone

Email

What day/times are you available to meet with a therapist? *

Who is your primary insurance provider? (We are in-network with all CareFirst/BCBS plans) *

What type of appointment would you prefer? *

In Person

Telehealth

State *

If you would like to, please briefly describe your concerns. *

How did you hear about us? *

Search Engine (Google / Yahoo etc.)

Friend or Family Member

Psychology Today

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Returning Client

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Takoma Therapy Promotion

Takoma Fest

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