Cultivate your life today Name * First Name Last Name Preferred Pronouns He/him He/they She/her She/they They/them Other Email * Phone * (###) ### #### Preferred method of contact * No Preference Email Phone What services are you interested in? * Select all that apply: ADHD assessments Individual therapy Clinical/licensure supervision Gender-affirming evaluation Group therapy Workshops/trainings What would you like to address: * Select all that apply: ADHD Anxiety Depression Grief LGBTQIA+ Life transition challenges Narcissistic relationships OCD Trauma Other Which state to you currently reside in? * Delaware Maryland New Jersey Pennsylvania Virginia None of the above Do you have a preferred therapist? Brittany Webb, LPC LCPC CCATP (MD, NJ, PA, VA) Jay Janicki, LPC LCPC LPCMH NATC (DE, MD, PA) Leah Pulli, LAPC NCC (PA) No preference What would you like us to know * Thank you! You will be contacted within 1-2 business days with your matched therapist!Are you located in Pennsylvania and want to schedule directly with a therapist? Schedule now. Let’s work together
