Contact Us

5036 Dorsey Hall Drive Suite 205

Ellicott City, Maryland 21042

Send us a message and we’ll get back to you in two business days.

(You may need to check your Spam email folder for our reply.)

First name

Last name

Phone

Birthday

Month

Day

Year

Your Insurance Provider

Do you reside in the state of Maryland?

Yes

Type of Session Requested:

In-Person

Virtual

First Available

Your Availability:

Referred By:

Are you interested in therapy for Disordered Eating?

Yes

First choice of clinician you would like to work with:

Second choice of clinician you would like to work with:

Third choice of clinician you would like to work with:

A Brief Description of challenges you would like to discuss (no more than 1-2 sentences):

Are you currently experiencing a mental health crisis or safety concern that requires immediate attention?

Yes

This is only for communication about the the content of the website. If you are experiencing a psychiatric emergency, please call 988 or Grassroots (410) 531-6677 or click on the logo below to enter into an instant messaging chat with someone from the Lifeline.

Contact Us

Send us a message and we’ll get back to you in two business days.

©2024 by Restorative Counseling and Wellness Center