From licensure to your first insurance contract, in order.
From: Mason Anglin, PsyD, LMFT, MBA — Advantage Coaching LLC
Why this is free: I don't charge for this. Some of the tools I recommend pay me a referral reward when you sign up through my link or invite. It costs you nothing, it often gets you a discount or free months, and I only recommend tools I use or have vetted. You get the same help whether or not you use them.
This is general business education, not legal, tax, or clinical advice. Rules change. Confirm with an attorney, CPA, or the BBS before you act.
1. Licensure
- Confirm your hours are complete and documented. Your logs and supervisor signatures need to hold up. Confirm current BBS rules.
- Schedule your exam. Work backward from your target licensure date.
- Know what you can't do before licensure. Associates generally can't run their own practice, advertise independently, or be paid as 1099 contractors. Confirm current BBS rules.
- Set a launch timeline. Plan the 3–6 months before licensure and the first 90 days after.
- Start a savings cushion. Setup costs and a slow first few months are normal.
2. Legal setup
- Check your employer agreement. Look for conflict-of-interest, non-solicitation, and outside-employment terms.
- Choose your entity. California generally requires licensed clinicians to practice through a Professional Corporation, not an LLC. Confirm with a California business attorney.
- Get a BBS Fictitious Name Permit if you'll practice under a name other than your own. Confirm current BBS rules.
- Get an EIN from the IRS. It's free.
- Get your city or county business license. Requirements vary by location.
- Calendar your Statement of Information with the California Secretary of State, if you form a corporation. Confirm deadlines with an attorney or CPA.
- Get your NPI. Type 1 for you as an individual, Type 2 for your organization. Confirm which you need for each payer.
- Get private-practice malpractice insurance. Employer coverage usually doesn't cover private work.
3. Business address
- Get a professional address before you file anything. Your address can appear on Secretary of State filings, the NPI registry, your BBS address of record, insurer directories, Google, and your website.
- Decide: mailbox or real office. A mailbox or registered agent works for mail and some filings, but not for seeing clients or Google Business Profile. A real shared office supports in-person clients, credentialing, and Google.
- Sacramento / Placer: West Roseville Counseling Offices, 1430 Blue Oaks Blvd, Roseville. Furnished offices, secure mail handling, Flex Membership ($99/mo + $15/hr for rooms) up to half-day and full-day leases. https://westrosevillecounseling.com
- West Roseville Counseling Offices is owned by Mason Anglin. I mention it because it solves this exact problem locally, but any compliant business address works.
- Alternatives: any virtual mailbox, registered agent, or shared therapy office with mail handling in your area.
- Confirm which address fits each filing with an attorney or CPA.
- Remove your info from data broker sites once filings go public.
- Incogni: https://incogni.cello.so/p9K3zLbNo6M — Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.
4. HIPAA
- Sign a BAA with every vendor that touches client information.
- Complete a security risk assessment and document it.
- Write your Notice of Privacy Practices.
- Create a telehealth consent.
- Use a HIPAA-compliant phone line instead of your personal number.
- iPlum (what I use daily): [affiliate link TBD] — Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.
5. Tech
- Pick an EHR for scheduling, notes, telehealth, intake, and billing.
- Build your intake packet: informed consent, financial policy, cancellation policy, releases of information.
- Set up your Good Faith Estimate process for self-pay clients (No Surprises Act). Confirm current requirements.
- Use HIPAA-compliant telehealth with a signed BAA.
- Set up a professional email on your own domain.
6. Money
- Open a separate business bank account.
- Set your fees and your sliding scale policy in writing.
- Run your break-even math: (income to replace + practice costs + taxes) ÷ collected per session ÷ working weeks = clients per week to break even.
- Set aside a percentage of every payment for taxes.
- Calendar quarterly estimated tax payments (federal and California). Confirm amounts and dates with a CPA.
- Heard (30-day trial invite via the intake form) — Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.
- Ask a CPA when an S-Corp election makes sense for you.
- Set up payroll if you elect S-Corp or hire.
- Gusto: https://gusto.com/r/mason2de8523f — Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.
7. Website, Google profile & directories
- Own your domain name in your own account.
- Choose your website path: DIY builder, WordPress + hosting, therapist-specific done-for-you, or have me build and host it. [link TBD]
- Include the essentials: who you help, location or "telehealth in California," fees and insurance, a booking button, license type and number (confirm current BBS rules).
- Make contact forms HIPAA-safe, or warn visitors not to share clinical details.
- Create one page per specialty, such as "Couples Therapy in [City]."
- Keep your name, address, and phone identical everywhere.
- Set up Google Business Profile only if you're eligible: a real in-person location during stated hours, or a service area. Mail-only addresses and telehealth-only practices risk suspension. Follow Google's current guidelines.
- Hide your home address if you set up as a service-area business.
- Create your Psychology Today profile.
- 6 months free invite via the intake form — Referral link: I may receive a referral reward if you sign up. It costs you nothing extra, and you get the same help from me either way.
8. Clients
- Write a clear "who I help" statement you can use everywhere.
- Respond to inquiries quickly with a HIPAA-safe auto-reply.
- Offer a short consultation call.
- Build referral relationships with local clinicians and providers.
- Don't solicit reviews or testimonials from current clients.
- Never confirm someone is a client when replying to a review.
- Keep advertising accurate: license type and number, no misleading claims. Confirm current BBS rules.
9. Insurance
- Decide your path: cash-pay, platform, direct contracts, Medi-Cal, or a mix.
- Complete and attest your CAQH profile.
- Enroll in Medi-Cal through PAVE if you're taking Medi-Cal.
- Know your Medi-Cal options: managed care plans vs. county specialty mental health.
- Track credentialing, contracting, and effective dates separately.
- Don't bill as in-network until you have your effective date in writing.
- Log every application with dates, reference numbers, and who you spoke to.
- Bill only for what you legitimately provide and document.
- If you have associates, confirm each payer's associate billing policy in writing. It varies by payer and plan.