Contact us

If you’d like to work with a B&B Well Counseling therapist or would like to schedule a consultation, please fill out the form below.

Name

First Name

Last Name

Age

Email

Phone

(###)

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Who is Therapy for?

Myself

Loved One

If Therapy is for a Loved One, Please List Their Name and Age

Have You or Your Loved One Tried Therapy Before?

Yes

No

Are You Looking for Virtual or In-Person Therapy?

Virtual

In-Person

What is Your Availability for Appointments?

How Did You Find Us?

Please List Insurance Information

Is There Anything Else We Should Know?

Direct Contact

170 Little East Neck Road
Suite 3
West Babylon, NY 11704