Employment Application

Simply Mindful Counseling is now accepting applications for full-time and part-time employment for fully licensed and limited licensed Clinicians (LMSW, LLMSW, LP, LPC), medical billers, and trauma-informed yoga instructors.

First Name

Last Name:

Phone

What is your primary Licensure or area of expertise?

What is your professional license number?

In what state(s) are you licensed?

In what year were you initially licensed?

Are you currently credentialed with any insurance companies?

Blue Cross Blue Shield

Blue Care Network

HAP

Not credentialed

Other

How many years of experience do you have treating patients in an outpatient psychotherapy setting?

How many patients would you desire to see per week?

How many years of experience do you have treating patients in an outpatient psychotherapy setting?

What are your preferred areas of specialization or interest? (Check all that apply).

Couples/Marriage/Relationship

Adults

Children (Under 11)

Adolescents (11-18)

Substance Abuse and Addition

Psychological Testing & Assessment

Perinatal/Post-Partum

LGBTQ and gender

Domestic Violence

Trauma

Grief & Loss

Please list any additional specialty practice areas or training beyond the educational requirements for licensure.

Are you looking to transfer patients from another practice?

Yes

What treatment approaches or theory drives your clinical interventions and why?

How would you describe yourself as a therapist?

How would you prefer to meet with patients?

Are you willing to work at least two evenings (5p-9p) a week?

Yes

Are you willing to work on the weekends?

I am willing to regularly work on Saturday

I am willing to regularly work on Sunday

I prefer not to work on the weekends

What are your wage/salary expectations?

Why are you interested in working with Simply Mindful Counseling?

Please submit at least two work or academic related references.

Please submit your cover letter or resume

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Thanks for submitting!

Info@SimplyMindfulCounseling.com

P: 734.335.0028

F: 734.335.3931

340 North Main Street, Suite 200
Plymouth MI, 48170

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