Insurance Verification — Black Space Therapy

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You're all set.

We've received your insurance information. A Black Space clinician will reach out within 24 hours to confirm your coverage and schedule your first appointment.

If you are in crisis, call or text 988.

🔒 Your insurance details are stored in our HIPAA-compliant system and never used for advertising.

Your information

First name

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Last name

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Phone

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Not you? Edit your info

Insurance information

Insurance carrier *

Member ID *

Insurance card *

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Front of card

JPG, PNG or PDF · Max 10MB

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Back of card

JPG, PNG or PDF · Max 10MB

✓ Your insurance card is stored in our HIPAA-compliant system. Only your therapy team has access.

When can we reach you?

Best times to call *

Mornings (8am–12pm)

Afternoons (12–5pm)

Evenings (5–8pm)

Anytime

Preferred contact method *

Anything you'd like us to know (optional)

By submitting, you agree to be contacted by a Black Space clinician.
HIPAA-compliant — your information is never used for advertising.

Complete your secure insurance verification

You're all set.