Registering for this site is easy. Just fill in the fields below, and we'll get a new account set up for you in no time.

Account Details

Profile Details

Name (required)

If you're signing up as a Licensed Treatment Provider enter your First and Last name. If you're signing up as a representative for a Clinic, Hospital, Treatment Center, or Organization enter the name of the company you represent.

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License Type (required)

These types of Licensed Treatment Providers can join the private community on Thero.org. Select any that apply to you.

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License Number (required)

Enter your license number. We use this to verify your identity.

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State where Licensed

The state licensing board for the license you listed.

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City

Primary city where you work.

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Zip/Postal Code

Primary Zip or Postal Code where you work.

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Website

List any publicly accessible website where your information is featured. We use the information on your website to help us verify your identity. If we are unable to verify your identity through your email, social media, phone number or other sources we may require you to provide additional information.

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Phone Number

The phone number where other providers in private Community can contact you. We use this for verification purposes.

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About Me

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My Interests

Select any that apply. This will help other Treatment Providers in the private Community find you by your interests.

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About Us

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Developer's Specialties

List the skills and specialties you'd like to feature to the mental health professionals on the Thero.org community.

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