Stillwell Journal

Starting a private practice in New York: a start-up checklist for therapists and counselors.

By Diana, founder of Stillwell · Updated November 8, 2026

Your first year in private practice is mostly paperwork, a few brave decisions and finding where to see clients. Here's a practical checklist for New York clinicians starting out in Brooklyn, in roughly the order you'll need it.

1. Confirm what your license lets you do

• LCSW, LMHC (licensed mental health counselor), LMFT, LCAT, psychologist: you can generally practice independently in New York.
• LMSW: in New York, clinical work like psychotherapy and diagnosis must be done under qualified supervision. Many LMSWs start part-time alongside a job while they earn hours toward the LCSW.

Check the NYS Office of the Professions for your exact scope before you set anything up.

2. Set up the business basics

• Business structure: many clinicians start as sole proprietors; others form a PLLC. New York LLCs and PLLCs have a publication requirement after forming, so budget for it.
• EIN and a separate bank account keep practice money apart from personal money.
• NPI number (free) if you'll bill insurance or work with other providers.
• Malpractice insurance before your first session.
• Paperwork: informed consent, a HIPAA notice of privacy practices, and your fee and cancellation policy.

This isn't legal or tax advice; an accountant who works with therapists is worth the hour.

3. Decide: insurance, private pay or both

Insurance panels and platforms that handle billing can fill a caseload faster; private pay gives you more control over rates and paperwork. Many Brooklyn clinicians start with a mix and adjust after six months. Panel credentialing can take a few months, so start early: most panels ask you to complete a CAQH profile first.

4. Pick your tools

• An EHR for notes, scheduling and billing
• A HIPAA-friendly video platform for telehealth sessions
• A business phone number and email that isn't your personal one

5. Choose where you'll see clients in person

This is the biggest fixed cost, so don't overcommit in year one.

Stage	What usually fits
0–5 in-person hours a week	Hourly rooms
5–20 hours a week	A weekly half-day or full-day block
25+ hours, steady caseload	Consider your own lease

Whatever you choose, check privacy first: soundproofing, a private waiting area and quiet entry. Our soundproof therapy office checklist covers what to ask on a tour, and lease vs hourly vs sublet compares the options.

Psychiatrists and psych NPs: look for an office rental that works for medication management: a desk and good lighting, space for a short check-in, and a front door patients can find easily. New York requires electronic prescribing, so confirm your e-prescribing setup before your first patient, and your DEA registration must list the practice address. Our page for psychiatrists has more.

6. Get found

• A directory profile (Psychology Today, TherapyDen, Zencare and similar)
• A simple website with your specialties, neighborhood and how to book
• Referral relationships with local therapists, psychiatrists, pediatricians and OB-GYNs

In Brooklyn, referrals from colleagues are often the fastest way to fill hours, which is why meeting other clinicians in person matters.

7. Protect your time

Set your cancellation policy, office hours and fees in writing from day one. Leave room in your schedule for notes, supervision or consultation, and rest.

Quick answers

What are the requirements to open a private counseling practice in NY?

You need a license that allows independent practice (for counselors, the LMHC), a business structure, an EIN, an NPI number, malpractice insurance, HIPAA-compliant records and paperwork, and a private place to see clients. If you form a PLLC, New York also requires publication after filing.

Can an LMSW start a private practice in New York?

In New York, LMSWs must provide clinical services like psychotherapy under qualified supervision, so most build hours in supervised settings or part-time arrangements before practicing independently as an LCSW. Check the NYS Office of the Professions for current rules.

What do I need to start a therapy private practice in NY?

Typically: a license that allows independent practice, a business structure (sole proprietor or PLLC), an EIN and business bank account, an NPI number, malpractice insurance, an EHR, and a place to see clients.

Should a new therapist lease an office?

Usually not in year one. Hourly rooms or a weekly half-day block let you grow your caseload without a multi-year lease. A lease starts to make sense around 25 or more in-person hours a week.