Application form: new Providers
Thank you for your interest in supporting our mission of suicide prevention. Thanks to our dedicated staff, as well as the generosity of our current providers, Nuçi’s Space is able to continue offering subsidized mental health services to those in need.
In order to persist in our mission of suicide prevention, our scope of services must continue to grow. As such, we are looking to expand our network of service providers. This allows us to offer a wide range of service options to our clients, meeting the unique needs of each individual, while also meeting the ever-growing need for mental health support in our community.
To ensure that the providers we partner with best serve our clients, we ask that all interested clinicians complete our application form (located at the bottom of this page).
In addition to completing the application, we ask that applicants meet the criteria listed below. Within two weeks of receiving your submission, a member of our Health & Wellness team will contact you to obtain any required documentation and move forward with the interview process.
Required Criteria:
A letter of recommendation and three professional references;
A background check;
The disclosure of all complaints filed against the therapist in the past;
Valid and current licensure, as well as proof of relevant accreditation;
Proof of liability and malpractice insurance;
Willingness to honor MOU (Memorandum of Understanding) and billing agreement as agreed upon by both parties and;
Sufficient evidence of competency in the areas of:
Suicidal ideation
Trauma support
Depression
Substance use disorder
Mood disorders
If the provider will be completing telehealth/virtual appointments, the provider should utilize a secure, HIPAA-compliant platform to host sessions for clients, including end-to-end encryption