Contact Form - NY Therapy Space - Therapy For Adults and Adolescents

Seek Support

info@nytherapyspace.com
(917) 905-4070

New York, New York 10022

Seek Support

First Name

Last Name

Telephone

Message

Do you have Out-of-Network Benefits?

I understand that this form should NOT be used for emergent or urgent issues. If I am having an emergency, I should call 911 or go to  my nearest emergency room. This form is not HIPAA compliant, thus not secure, and use of it is at my own risk. I understand that I should  avoid inclusion of any sensitive medical information that I wish to be protected. By using this form I am consenting to this.  Furthermore, Contact does NOT establish a clinician-client relationship.

info@nytherapyspace.com
(917) 905-4070

New York, New York 10022