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Include Your Information for the PSI-NC Resource List!
Postpartum Support International - North Carolina (PSI-NC) is creating a state-wide resource list for professionals who are treating perinatal mood and anxiety disorders (PMADs). The PSI-NC resource list is used by PSI State Coordinators to connect people impacted by PMADs to professionals with the expertise necessary for adequate treatment. To apply for inclusion on this list, please submit the form below. If you have any questions you may email psi.nc.chapter@gmail.com for more information. * You may also update existing information using this form.
Do you wish to join or remain on the PSI-NC resource list? Note: Only PSI North Carolina State Coordinators can access the information.
Type of practitioner
First name
Your answer
Last Name
Your answer
Credentials
Your answer
Organization/Business (If more than one, please list primary here and secondary in the comments.)
Your answer
Office Address
Your answer
City
Your answer
State
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Zip code
Your answer
Phone
Your answer
Is it okay to share your phone number with prospective clients?
Work Email (to be shared with potential clients)
Your answer
Email (for communications with PSI-NC)
Your answer
Website
Your answer
Please select any insurance you accept.
Do you offer sliding scale appointments?
Do you provide tele-therapy?
Do you offer home visits?
Have you completed the PSI/2020 Mom online training? http://www.2020mom.org/individual-certificate-training/
Additional specialties, training and certifications (For example, EMDR, CBT, DBT, etc)
Your answer
Years of PMAD experience
Your answer
If you are able to provide care in languages other than English, please list them below.
Your answer
Please list below if you possess any intercultural skills (knowledge of different cultural contexts and viewpoints) inclusive of, but not limited to: race, ethnicity, gender, class, disability, sexual orientation, gender identity or expression, immigration status and faith or spirituality.
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County or Counties you serve
Comments (If you operate in more than one location, please include all contact and insurance info for those locations here.)
Your answer
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