Appointment Request
Facebook
Instagram
LinkedIn
Home
About
About Northstar
Locations
Counselor Network
How to use EAP
Employer
Employee & Student Assistance Programs
Trainings, Seminars, & Consulting
Northstar Resource Portal
Request for Proposal & Brokers
FAQ For Employers
Employee
TESS (Free virtual chat service)
Request an Appointment
Northstar Resource Portal -employee login
FAQ For Employees
FAQ for TESS
Information & Resources
Blog
Courses & Cohorts
Trainings, Seminars, & Consulting
Mental Health Links
Northstar Business Partner Assessment
Partner with Northstar as a Counselor
Counselor Name
*
First
Last
How many years of counseling experience do you have?
*
Please explain why you want to partner with Northstar EAP?
*
Do you currently have your own practice?
*
Yes
No
What is the name of your practice?
*
Best phone number and email to reach you:
*
Do you plan on continuing your private client counseling?
*
Yes
No
What is your area of focus/specialty?
*
Please list your current credentials, effective and expirations date, if applicable:
Are you open to, or already using, Tele Counseling and/or Virtual Counseling?
*
Yes
No
Do you use, or do plan, to use a HIPAA compliant platform for these services?
*
Yes
No
Which platform do you use or plan to use?
*
What days/times can you make available for Northstar EAP Clients?
*
Please provide a copy of the following:
*
Resume, Evidence of State licensure, and Evidence of current malpractice insurance (1mil/3mil) - PDF, DOC, and DOCX formats accepted through this online form.
Drop files here or
Select files
Accepted file types: pdf, doc, docx, Max. file size: 20 MB.
CAPTCHA
Number
Name
This field is for validation purposes and should be left unchanged.
Home
About
About Northstar
Locations
Counselor Network
How to use EAP
Employer
Employee & Student Assistance Programs
Trainings, Seminars, & Consulting
Northstar Resource Portal
Request for Proposal & Brokers
FAQ For Employers
Employee
TESS (Free virtual chat service)
Request an Appointment
Northstar Resource Portal -employee login
FAQ For Employees
FAQ for TESS
Information & Resources
Blog
Courses & Cohorts
Trainings, Seminars, & Consulting
Mental Health Links
Northstar Business Partner Assessment