Let’s get in touch. Fill out some info and we will be in touch within 48 hours. Consent for Communication By checking this box I consent to phone calls, SMS text messages, and emails from a staff member at Mallin Counseling LLC. Name * First Name Last Name Email * Phone (###) ### #### What type of therapy are you looking for? * Individual Couples Partner's Name (If seeking couples therapy) First Name Last Name Partner's Email (If seeking couples therapy) Partner's Phone (If seeking couples therapy) (###) ### #### Is person receiving services under the age of 19? * Yes No Provider Preference Victor Mallin (Accepting couples for waitlist, private pay only) Mallory Mallin (Accepting individuals for waitlist, Thursdays only) How did you hear about us? Who is your insurance provider or are you doing private pay? Currently, providers at Mallin Counseling are only in-network with Blue Cross Blue Shield and Midlands Choice. However, we're happy to provide a superbill for out-of-network benefits. Briefly share your reasons for seeking out therapy. * Availability Morning (8-11am) Afternoon (12-3pm) Evening (4-6pm) Thank you! One of our providers will be in touch within 48 hours.