Your Professional Credentials

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CredentialsAdd your license details
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Please provide your professional license information exactly as it appears on your license. This helps us verify your credentials and build trust with potential clients.

Mativa is a platform for New York State mental health professionals providing perinatal mental health services. Eligible providers include licensed clinicians and certain clinicians practicing under appropriate supervision in accordance with New York State requirements.

Providers must accurately represent their license or permit status, credentials, supervision status (if applicable), and the services they are authorized to provide.

License Type *
Licensed In *
New York is required and pre-selected. Hold Cmd (Mac) or Ctrl (Windows) to select additional states.
License Number *
License Expiration Date
If your license does not expire, leave this blank.
Supervision Information
If you are practicing under supervision as required by New York State, please provide the following information.
Are you currently practicing under supervision? *
Supervisor Name *
Supervisor Credential / License Type *
Supervisor License Number (if required)
Confirmation *
Terms and Eligibility
I have read and agree to the Therapist Listing Agreement and Terms of Service, acknowledge the Privacy Policy, represent that I am authorized to submit and manage this Listing, and authorize the recurring charges disclosed at checkout.