Professional Documents
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Starting A Private Practice in Counseling Checklist.04
Starting A Private Practice in Counseling Checklist.04
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You might like to print out pages 2 & 3 to check these items o as you go, while you
follow along using the clickable links in the rest of this PDF.
So take a deep breath, carve out a bit of time to chip away at this every week, and just
tackle one item at a time. You got this!
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Build your website
Implement other aspects of your marketing strategy
Develop a communication system for waitlisted clients
HIPAA-secure email and phone setup
Decide: are you o ering in-person counseling?
Find a therapy o ce or create a home teletherapy o ce
Furnish/decorate your o ce
If applicable: HIPAA-secure teletherapy platform
If applicable: Telehealth certi cations
If applicable: Get a city business license
Set up a business bank account
Get great headshots
Set your rate
Decide on paper or electronic charting and choose a practice
management system
Get informed consent and essential paperwork ready
Choose a bookkeeping system
Accepted forms of payment
Develop your screening process
Join online directories
Analyze and tweak your marketing strategy
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Let's dive into the details for each of these checklist items. This is a really meaty page
because I want it to have everything you need on your checklist when starting a
private practice in counseling.
So pour yourself a cup of co ee, take a deep breath, and remind yourself: you got this!
I'll help you along, step-by-step.
Disclosure: Private Practice Skills uses a liate links. This means that when you make
a purchase through my links I may earn a commission, which helps me continue
creating more awesome content for you. Please know that I only recommend products
that I know and trust.
My suggestion is to approach colleagues who are already in private practice and ask
about their experiences. This will help you develop a sense of what it's like and
whether that experience is something you want. If you don't already know therapists
in private practice, check out local Facebook groups for therapists and start there.
Here are some more resources to help you tackle this step:
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Why does your NPI number matter? It's a way of keeping track of each health care
provider in the nation. It's almost like your therapist social security number, but it's
publicly accessible. Most often I need my NPI number when interacting with insurance
companies. It's also a key piece of information to include in a Superbill.
Not sure where you left that NPI number? Go to www.npinumberlookup.org to retrieve
it. Need to update your address or other information for your NPI? You can do so with
the NPPES.
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You likely need to purchase liability insurance before signing a lease, as many
landlords require proof of insurance before accepting a new tenant. But insurance is
quick to sign up for and you can print out proof of insurance right away once you sign
up. Of course, you do have to pay the annual fee all up front! (aka: cha-CHING!)
In a little bit we'll talk about business entities. It's worth making sure your insurance
covers you not only if you're a sole proprietor, but also if you're an LLC or a
corporation. Most experts suggest therapists get coverage of
$1,000,000/$3,000,000 limits. If you're lucky enough to have more assets than that,
then make sure you up the coverage to keep all of your assets protected.
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the LLC option is ideal since it protects your assets the most from any potential
lawsuits. However, not every state allows therapists to le as an LLC.
Not ready to le as an LLC or S Corp yet? No worries! Just keep in mind which you
intend to le as because you'll need that handy for the next step.
However, using your social security number quickly presents an issue. When
interfacing with insurance, they need to know your identi cation both through your
NPI number and your EIN. If you don't have an EIN, then you need to use your social
security number for clients to apply insurance bene ts towards counseling.
If you o er your clients a Superbill for out-of-network billing, you need to put that
number on the form. NEVER put your social security number on any paperwork you
give out to clients! Instead, get an EIN. It's fast, easy, and free. So why not?
Want to apply for an EIN? Here are the EIN application instructions on the IRS
website. The whole process took me all of 20 minutes.
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8. decide: insurance-based or cash pay
practice?
This is a big question! Of course, you can always start out accepting only cash pay and
add on insurance panels later. Keep in mind that once you're on an insurance panel,
it's not as simple to back out of it. You usually need to phase out slowly unless you
don't mind dropping care for several of your clients at once or on short notice.
The process of getting accepted onto insurance panels usually takes at least 3 months
or longer, so it's good to jump on this as soon as possible.
This is also a great time to decide if you would like to be available as an out-of-
network provider. This is as simple as providing a Superbill for clients to submit to
their insurance for reimbursement.
It's a little bit of extra work up front, but it's a great way to allow clients to apply
insurance bene ts towards therapy if you're not in-network on any insurance panels.
There are other third party payers for counseling, including victims of crime
compensation (links to the CA website) and workers' compensation, to name a couple
of examples. Feel free to explore your options before deciding who to accept payment
from.
Here are some resources to help you make decisions on the above topics:
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To help you get started, you can check out these resources:
This is a helpful place to start for your marketing strategy because your brand story
really guides the direction of every marketing decision for your practice. Your brand
story allows for your passions to inform the purpose and direction of your practice.
Don't worry, I have lots of tools to help you develop your brand story! Feel free to check
them out:
Your specialties and niche build on your brand story. Your specialties refer to what
kind of therapeutic modalities you o er and to whom (e.g., group counseling for
partners of addicts, individual therapy for angry teens).
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Your niche refers to the nuanced way that you present your business to the world. It's
not absolutely 100 percent necessary to know your niche at this point or even to have
one nailed down later on, but you might nd it really clarifying to explore.
Here are some tools to help you with your specialties and niche:
We're getting to the fun part! Your website is such a key depiction of your brand, your
specialties, and WHO you are as a therapist and as a practice. It's also an incredibly
key part of any marketing strategy.
In fact, I think your website is so important that I built my rst course entirely around
how to build a website that lls your practice with zero ads. I show you how to create
your entire website from scratch using Squarespace. It will make this step a whole lot
easier!
Prefer to build your website from Wordpress? My friend Daniel Fava from Create My
Therapist Website has a full course showing you how to do that, every step of the way!
Check out the course: Create My Therapist Website Toolbox 2.0.
Here are some more resources to help you with your website:
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Believe it or not, now is the best time to market your practice! Ideally, if your
marketing strategy is working then you can start building a small waitlist so you have
clients ready to meet with you once you make it through the remaining steps in this
checklist.
So start plugging away at any other aspects of your marketing strategy you developed
- public speaking gigs, networking, blogging, etc.
Though we are allowed to have a waitlist in private practice, there is a proper way to
do it. The key components include ensuring you've o ered appropriate referrals
elsewhere if someone wishes to see a therapist sooner, and clearly communicating
your plan for opening.
Create a system for how you will communicate about your waitlist to potential clients.
You might consider adding a clear disclaimer on the contact page of your website that
includes your intended open date and how clients can reach you if they wish to meet
with you once you open your doors.
You might also nd it helpful to watch my video: The Ethical Way to Have a Waitlist in
Private Practice
Though you might be tempted to use your personal phone number and email to start,
let me steer you away from that option! There is just too much of a mess waiting to
happen with HIPAA if you go that route.
There are several phone options available to use, ranging from free to pricey. Same
with email. Generally speaking, you need to pay a little money to make sure your
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phone and email are HIPAA-secure. If you want to have the highest level of end-to-end
encryption then you may need to pay a little more for a service like Hushmail (this is
an a liate link).
One option is to set up Google Workspace to be HIPAA-Secure and use that email for
basic communications like scheduling. For communications that are more personal,
you can send secure messages via your EHR (more on that later). I love using Google
Workspace because you have access to their full suite of services, not just email. You
can have a HIPAA-compliant email account for just six bucks a month. Here's some
more information on how to setup those tools:
One option is to start o by o ering teletherapy from a home o ce and building your
practice "on the side" until you're ready to take the plunge to in-person sessions. Or if
you're like me and you love seeing clients face-to-face when possible, then you can
hop into an o ce space right away.
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This is the step of starting a private practice when things start to feel real. To me, the
o ce was the symbol of legitimacy when I felt like: I guess I'm really doing this!
I typically suggest starting out part-time in private practice rather than diving into
full-time private practice head rst. The initial investment of a part-time o ce is
much more manageable and you're far less likely to run into cash ow problems if you
don't end up turning a pro t right away.
Finding a therapy o ce is at least as stressful as nding a place to live. Let me help
you take the mystery out of it! Here are some resources to help you nd an o ce
space:
Furnishing your O ce
If you followed tips from my resources above, then you'll likely sublet an o ce that's
already furnished. But, if you're the kind of person who is taking the full-on plunge into
your own o ce space, then you likely need to furnish it yourself.
I don't know about you, but I love any excuse to design a new space! It can also be one
of the priciest parts of starting a full-on practice. Keep this in mind and consider
subletting an already furnished o ce before arriving at this step.
Ready to dive into furnishing your o ce? Here are some tips to help:
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Are you skipping the conventional o ce and setting up camp at home? It's not quite
so simple as sticking a computer in a room and closing the door for sessions. But it is
incredibly doable and, did I mention, cheap? Here are some tips to get your home
o ce therapy-ready:
You don't have to sign up for a teletherapy platform just yet if you're not quite ready to
see clients at this point, but it's good to do a little research and decide which route you
plan to go. It's also worth noting that several EHRs like TherapyNotes o er a HIPAA-
secure telehealth platform that you might decide to go with.
Here's some information about some of the most popular teletherapy platforms:
Chances are, you don't need any extra certi cations to provide teletherapy. However,
this is a good time to double-check with your state governing board to see if they
require certi cations for you to provide teletherapy.
Sometimes your liability insurance may require that you get a special certi cation in
order for your teletherapy services to be covered. Double check on this and get
whatever required certi cations might pop up along the way.
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Not every city requires a business license. If that's the case for you, count yourself one
of the lucky ones! Otherwise, now that you have a business address it's time to
complete the application and pay the fee. You're likely required by your city to have
this license posted in plain view within your o ce, so check if there are any similar
requirements and follow suit.
If this step seems overwhelming, it's not too complicated! To learn more, check out
these resources to help you get your business account set up:
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Y'all. We are professionals. We can do better than that! Even if you don't want to fork
out any money and you don't have a fancy camera, put in the time to get ready and
have someone take a photo of you in nice lighting using a smartphone.
Often clients tell me they picked me because I "looked like a nice person" in my photo.
Though I like to believe all the e ort I put into my website content is what's paying o ,
I can't deny my headshots are also a key factor in my marketing strategy.
Want to learn more tips for a great headshot? Check out my video: Private Practice
Marketing Tip: Great Headshots
Setting your rate shouldn't have to be a guessing game. You can gure out how to set
your rate so that you charge the right amount to earn the income you want. Here are
some resources to help you set your rate and know your expected annual income
before seeing any clients:
Now is also a good time to decide if you will o er a sliding scale. You can learn more
about that in my video: Should you O er a Sliding Scale in Private Practice?
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17. decide on paper or electronic charting and
choose a practice management system
You have a decision to make about whether you prefer to do paper charting or if you'd
like to go with an electronic practice management system. Of course, you can also
start with paper and then migrate over later if you choose.
The good news about EHRs is they tend to provide several essential services in
addition to secure charting, like help with billing, scheduling, and o ering a HIPAA-
secure telehealth platform.
TherapyNotes o ers all of these services and more. If you'd like to try out
TherapyNotes for two months for free with no commitment, then click the link here in
order to get it!
And should you like to go the old-fashioned route of pen and paper charting, then
don't forget to purchase a le cabinet. If you're subletting your o ce, you may need to
purchase a small portable locking le cabinet. In my early days, I used this one.
Check with your local governing jurisdiction to make sure you include all required
components in your paperwork.
One option I recommend is to take all the guesswork out of your paperwork with the
Private Practice Startup's awesome paperwork package. Kate and Katie have spent
over 100+ hours studying the laws, rules and ethics and paid thousands of dollars in
attorney fees so you don’t have to. Pretty sweet right?
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Grab your customizable, attorney-approved private practice forms here with these
sweet coupon codes:
If you do wind up going with an EHR like TherapyNotes, they have templates available
within the platform that you can tailor for all of your paperwork needs. You can also
start there and tailor those to your needs.
If you're starting from scratch, here are a few resources to help you out:
For me, logging my expenses and revenue at the end of every month is an important
ritual in seeing what strategies are worth continuing to pay for and where I might like
to change my focus in the future.
After I tally my expenses and revenue for the month, I subtract percentages for my
retirement plan and taxes. The leftover is the paycheck I cut myself for the month.
Easy peasy!
Okay, I know for most folks this process doesn't feel so easy peasy. Fortunately, Heard
Bookkeeping and Tax o ers an all-in-one accounting platform that is designed
speci cally for therapists.
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If you’re looking for seamless, all-in-one accounting support speci cally tailored to
your private practice needs, Heard might be a great t for you. Click here to learn
more about what Heard o ers.
Here are some resources to help you learn more about keeping track of your nances:
Here's the thing: it's only about once a quarter that a client will pay me in a form of
payment other than swiping plastic. In other words, EVERYONE pays with card.
Also, back when I was a pre-licensed intern in private practice, I only accepted cash or
check payments. People forgot to bring payment so often that I spent a few hours
every month chasing down outstanding balances.
My suggestion: when you set your rate, assume everyone will pay with card and tag on
an extra ve dollars to what you would charge if everyone paid cash. You will earn
more in the end because you won't have near as many outstanding balances. I mean, I
don't know about you, but I personally don't lug around a checkbook or massive wads
of cash anymore.
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Lastly on this topic: Now is a great time to consider accepting HSA/FSA payments. A
signi cant amount of my clients pay for counseling using Health Savings Accounts or
Flexible Spending Accounts (they charge just like a credit card!). I'm able to do this
using my Square reader. You can also charge clients through IvyPay or your EHR like
TherapyNotes.
Most potential clients initially contact me via email. My typical process is to schedule
a free phone consultation to answer questions they may have and to ensure we're a
good t to work together. I also encourage them to explore other therapists in the area
to nd the right t before scheduling an appointment.
Once you schedule the rst session, it's helpful to have a standardized con rmation
sequence. For me, I ask permission to con rm our appointment via email. Within the
email, I include information about where the o ce is located, fees, accepted forms of
payment, and initial forms to complete. You can snag my Free Sample Appointment
Con rmation Email Template and tailor it to your needs.
If our appointment is scheduled more than a week in advance, I like to send a reminder
email a day prior in order to minimize no-shows (no-shows are more common for the
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rst appointment than future appointments). You can also use scheduling software or
your EHR to automate appointment reminders.
Here are a few tools to help you develop your initial screening process:
Once a free trial is up, you can cancel any that aren't paying o . Here are some of the
more popular directories:
• Psychology Today
• Inclusive Therapists
• Therapy Den
• GoodTherapy
• Directory for Therapists
• Theravive
• Find-a-Therapist.com
• Therapy Tribe
• Therapist Locator
• Network Therapy
There are also many directories that cater to speci c specialties, such as EMDR,
LGBTQ+, and Faith-based directories. Feel free to explore whether there are directories
that funnel directly to your speci c specialties.
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Also be sure to get listed with Google my Business. It's completely free and it gives a
HUGE boost to your practice. It helps with your website's SEO (it makes your page
more likely to appear closer to the top of a Google search), and also pops up on
Google maps. You can learn how to optimize your Google My Business pro le to show
up at the TOP of Google search results with my training: The GMB Secret.
You might also consider adding yourself to Yelp, Facebook, Instagram, and other
directories to give your practice more credibility and make it easier for people to nd
you. You can get a full list of such directories in Backlinkfy's article, Top 50 Free USA
Business Directories To List Your Local Business. I took a rainy afternoon and made
free listings all over the internet!
Video: Are you Making these Mistakes on your Psychology Today Pro le?
Article: How to Market Counseling Services using Google My Business
Video: Why you Need Google My Business for your Therapy Private Practice
Video: The Do's and Don'ts of using Instagram to Market your Private Practice
At this point, you've likely taken at least a couple of weeks if not a few months to make
it through the entire checklist here. Since you've clocked some time utilizing your
initial marketing strategy, go back and analyze what strategies are working. This is
the time to tweak and hone your marketing strategy, so you're not wasting time or
money on things that aren't e ective, and you're only investing in strategies that work.
It's a great idea to get Google Analytics set up so you can access detailed information
about who is visiting your site. You can also use a free tool like Ubersuggest to get
access to some helpful data about who is nding your site through Google search and
how they're getting there.
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You can access step-by-step tools for developing and analyzing your marketing
strategy in my mini course: Client Attraction System.
And until next time, from one therapist to another: I wish you well!
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