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home > providers > becoming a provider
 
Becoming a Provider
 
An Empathia Affiliate must have a minimum of a Master's degree in a human services related field, be independently licensed in the state in which he or she practices, have at least 5 years of post-graduate clinical experience and have extensive experience in the EAP field.
 
You may obtain an Empathia Affiliate Application form in one of three ways:
  • Download an application form from this Web site, complete it and return it to Empathia.
  • Call Empathia at 1-877-844-8693 extension 5.
  • E-mail Empathia here
Upon receipt of your application, we will add the information about your practice to our resource directory. We will then contact you directly if services are needed in your area.
Affiliate Application (Fill out online and print)