Start a Private Therapy Practice

Licensed clinicians stay in agency jobs for years; demand for therapy far outstrips supply, and telehealth cut the cost of going independent.

1. 1

   Confirm your licensure path

   Verify your state license allows independent practice (fully licensed, not associate-level in most states) and check supervision or telehealth rules if you plan to see clients across state lines.

2. 2

   Choose telehealth or sublet

   Telehealth-first keeps overhead near zero; a sublet office one or two days a week costs $200 to $600 a month. Do not sign a full lease before you have a caseload.

3. 3

   Set up the legal entity

   Form a PLLC or professional corporation per your state's rules, get malpractice insurance, an NPI number, and an EIN. This week of paperwork protects your license and your house.

4. 4

   Decide insurance or private pay

   Credentialing with two insurance panels takes 60 to 120 days but fills a caseload fast; private pay at $120 to $200 per session pays more per hour. Many practices start with one panel plus private pay.

5. 5

   Pick a HIPAA-compliant EHR

   SimplePractice or TherapyNotes handles scheduling, notes, telehealth video, and billing in one subscription. This replaces an entire front office.

6. 6

   Open your referral channels

   A Psychology Today profile, a simple website with online booking, and outreach to local physicians and agencies that overflow. A specific niche (couples, trauma, teens) fills faster than 'general therapy'.

7. 7

   Fill the caseload deliberately

   Twenty clinical hours a week at private practice rates typically out-earns an agency salary. Track inquiries to bookings and adjust your niche messaging until the waitlist forms.