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Juneau Mental Health Listing

For people who are new to being listed on Juneaumentalhealth.org, please fill out this form. This form is also used to update current listings. If you have any questions, you can email us at namijuneau@gmail.com

Please answer every question. If the question doesn't apply to you, write 'N/A'. If you are updating a current listing and have questions you don't want changed write 'same' in those boxes.

Thank you for serving our wonderful community!

Name (First and Last)

Credential(s) *

(i.e. LPC, LCSW, PhD, etc.)

Name of your practice (if applicable) *

Accepting new clients? *

yes, no, is there a waitlist?

Populations Served *

Specialties *

list conditions/situations that you can help with

Do you specialize in working with veterans? *

yes/no and any additional details

Do you offer substance use recovery services? *

yes/no and any additional details

What modalities and trainings do you use in your practice? *

Insurance and payment details *

if you accept multiple insurances, please list them so we can make this searchable.

Other comments *

Website *

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Phone *

Email *

Verify Email *

Do you offer telehealth, in-person or both? *