Full Name
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Email
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Phone
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I am interested in accessing counseling through:
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BlueCross BlueShield of North Carolina
Superbill for an out of network insurance plan
Aetna
Private Pay
Available for recurring appointment:
8-10am
10-12pm
12-1pm
1-4pm
4-7pm
Preferred Provider
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Mackenzie Paolacci (Family/Individual Counseling)
Aidan Johnson (Couples/Individual Counseling)
Audriana Hogg (Couples/Individual Counseling)
Alicia Snell (Individual Counseling)
Amanda Espinosa (Individual Counseling)
Shaylyn Bradshaw (Individual Counseling)
Courtney Jost (Individual Counseling)
Whoever has immediate availability
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Any questions or additional information we should know:
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I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.
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I understand that electronic forms of communication should not be used to discuss therapeutic content and/or request assistance for emergencies. Please only include necessary information concerning your appointment needs or general questions. If you opt to utilize electronic forms of communication to discuss therapeutic content, there is no guarantee of absolute confidentiality.
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