creasman counseling, pllc
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Counseling & Medication Management Request
If you are unsure if you would like medication, but would like a consultation, please complete this form.
*
Indicates required field
My name is...(first name, last initial
*
First
Last
My insurance is
*
Blue Cross Blue Shield (including Anthem and the State Health Plan
Aetna
Cigna/Evernorth
Medcost
Medicare
Tricare
United Healthcare/UMR
Other
I will not be using insurance
Please note that we are not in network with Blue Value, Blue Home, or Blue Local plans.
The first four characters of my insurance member ID are
*
If you are not using insurance, please enter "NA."
I would like to meet...
*
In person
Virtually (video telehealth)
Either
For counseling, I'd like to meet with...
*
Adam Brandt
Aisha Al-Qimlass
Anna Smith
Beth Vincent
Candice Creasman Mowrey
Katharine Johnson
Kelly King
Melissa Rakowitz
Nikki Birkenstock
Perihan Akcan Aydin (türkçe konuşuyor)
Solana Wild
Taylen Harp
Yailyn Murphy (habla español)
I'm not sure
For medication management, I'd like to meet with...
*
Michelle Helms, PMHNP-BC, PMH-BC
Tirrini Hill, PMHNP-BC, PMH-BC
First available
I'm seeking help with...
*
Depression
Anxiety
Trauma
Career
Relationships
Body Image/Self-esteem
Substance use concerns (myself or family)
Identity (race, gender, ethnicity, sexuality
Parenting
Panic attacks
Perinatal mental health concerns
My child or adolescent
Something else
Check all that apply.
If you checked "something else," please describe.
*
Have you ever been diagnosed with or suspect that you have ADHD?
*
Yes
No
Please contact me by...
*
Phone
Email
Please enter your phone number or email
*
Is there anything else you would like us to know or questions you have?
*
What county in North Carolina are you located in?
*
What is your preferred language?
*
English
Spanish
Turkish
How did you hear about us?
*
Submit
Home
About Us
Providers
Administrative
Leadership
Services
Individual Counseling
Medication Management
Reduced-Fee Counseling
Groups
Clinical Supervision
Resources
FAQs
Rates & Insurance
Good Faith Estimate
Crisis Resources
Practicum & Internship
Audio & Video
Podcast
Client Portal
Contact