So You Want to Start a Private Practice? Here’s the Roadmap (2 of 2)

Beginning your private practice, step-by-step...

It's been 6 years since I started my private practice and I love it.

If the first part of this series was about why private practice can be so fulfilling, this part is about the how.

Starting a private practice sounds intimidating, but step by step, it’s doable. In fact, you don’t need much more than liability insurance, a way to accept payment, and a place (physical or virtual) to meet clients. Everything else builds from there.

1. Get Liability Insurance

The basics: you need professional liability insurance (malpractice coverage). Most clinicians I know use CPH & Associates. It runs about $300/year and even gives you a free Psychology Today profile for the first year (which is one of the most reliable referral pipelines out there).

2. Register with CAQH (Credentialing)

This is the not-so-fun part, but essential if you ever plan to take insurance. CAQH ProView is a free database where insurance companies verify your credentials. You’ll need your degree, license info, insurance certificate, resume, and NPI number. It’s clunky, but once you’re in, you’re in.

It’s been six years since I started my private practice, and I love it.

3. Choose a Practice Management Platform (Your EMR)

This is where you’ll chart notes, handle billing, and run telehealth sessions. These platforms are called EMRs (Electronic Medical Records).

My personal favorite is SimplePractice. It’s easy to use, HIPAA-compliant, and all-in-one. If you sign up with my link and stick with it for three months, we both get $200 in credit (yes, it helps keep my lights on — thanks in advance).

Other EMR options include TherapyNotes, TheraNest, and Kareo. But no matter what you choose, an EMR is the backbone of your practice: notes, scheduling, billing, and telehealth all in one place.

4. Decide How You’ll Take Insurance (Headway, Alma, or the Old Way)

Here’s where a lot of therapists get tripped up. Historically, the way to accept insurance was to get “paneled.” That meant applying individually to each insurance company, waiting months (sometimes longer), and then handling billing yourself. Many clinicians still do this, but it’s paperwork-heavy and slow.

Now there are companies that simplify everything:

• Headway: Free, fast, and handles insurance credentialing and billing for you. It took me about five days to get cleared.

• Alma: Another good option with a similar model.

Think of these as your “insurance office.” They credential you, bill for you, and pay you — so you don’t have to become an insurance admin on top of being a therapist.

I personally use SimplePractice for my notes and telehealth, and Headway just for insurance. You could do the reverse, or use Headway/Alma alone if you don’t want to manage your own billing.

5. Decide on Business Structure

You don’t need to form an LLC. You can run your practice as a sole proprietor. But an LLC adds protection and makes bookkeeping cleaner. Either way, it’s worth opening a separate bank account for your practice.

6. Build Your Online Presence

Again, you don’t need a website — but it helps. A simple landing page gives clients a place to learn more about you and reach out. Squarespace, Wix, or WordPress can get you set up quickly. Psychology Today often works as your first “website” until you’re ready.

7. Telehealth Is Here to Stay

The pandemic didn’t just normalize telehealth, it made it essential. That’s good news and bad news. Good news: your client pool is now national. Bad news: your competition is too. Being clear about who you are and what makes you different has never been more important.

Final Thoughts

There’s a real liberation in private practice. You get to decide how many clients you want, what kind of clients you want, and how you want to run things. You can keep it small — just a handful of clients alongside another job — or you can scale it into your full-time livelihood.

Either way, it’s yours.

Disclosure: Some of the links here are referral links. They help keep this site running (and yes, occasionally help me buy coffee). If you use them, thank you.