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Request a Verification

If you need to verify credentials of multiple psychologists, please email amila@nationalregister.org.

Psychologist Information:
Name*
First Last
Name
First Last
Email*
Purpose of Verification*
If other, please specify*
Please send verification to:
Licensing Board*
State/Organization:*
Contact Name*
First Last
Email*
Email
Can we send verification via email?
- Yes
- No
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Special Instructions
Who is submitting this request?*
Are you the Registrant or are you an employer, healthcare organization, etc., requesting to verify provider credentials?
- National Register member
- Employer, healthcare organization, other