Georgia Psychological Treatment Center

Name *

First Name

Last Name

Phone *

Please provide the best number to reach you.

(###)

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Interested in Which Provider? *

Any provider/No preference/Not applicable

Gaelyn Coefield (therapy/counseling)

Valdesha DeJean (medication and therapy/counseling)

Sharae Hanley (therapy/counseling)

Charrise Huston-Arnold (therapy/counseling)

E. Simone Kennedy (therapy/counseling)

Chantel Kufeji (therapy/counseling)

April Lewis (therapy/counseling)

Lydia Odenat (therapy/counseling/testing)

Leslie Sheridan (therapy/counseling)

Samantha Speed (therapy/counseling)

Sharon Williams (therapy/counseling)

Which Insurance?

No insurance/Self pay

Aetna

Anthem/Blue Cross Blue Shield

First Health

Humana

Meritain Health

Tricare

United Healthcare -Student Health Plan

United Healthcare - Commercial (NOTE: we are out-of-network)

Cigna (NOTE: we are out-of-network)

Other

Do you prefer virtual or in-person appointments?

Virtual

In-person

Both/No preference