Application Submission

Name *
Name
Phone Number *
Phone Number
Are you currently licensed in New York State as a LCSW or LCSW-R? *
How many years of experience do you have performing individual therapy? *
How many years of experience do you have working with seniors or individuals with chronic medical conditions? *
Are you bilingual? *
If employment is offered, are you willing to complete a criminal background check? *
Do you have any daytime availability to meet with clients Monday through Friday? *
What areas are you willing to work within? *

PO BOX  330

COMMACK, NY 11725

(516) 698-5511