How to Start a Private Practice Without Feeling Overwhelmed

How to Start a Private Practice Without Feeling Overwhelmed

Meredith Hrebenak, MS, LPC, NCC

Starting a private practice as a therapist is an exciting but daunting journey. You’ve spent years developing your clinical skills, but now you need to learn how to be a business owner, marketer, and administrator—all while still helping your clients. It’s no wonder many therapists feel overwhelmed by the process!

The good news? You don’t have to do it alone. In this guide, I’ll walk you through a step-by-step approach to starting your private practice in a way that feels manageable, not stressful. By breaking it down into clear, actionable steps, you’ll be well on your way to building a successful and sustainable therapy practice.

Step 1: Define Your Private Practice Vision

Before diving into logistics, take some time to envision your ideal private practice. Ask yourself:

  • What type of clients do I want to work with?

  • What therapy modalities do I enjoy using?

  • Do I want to accept insurance, or will I be private pay only?

  • Do I want an in-person office, a fully remote practice, or a hybrid model?

  • What work-life balance do I want to maintain?

Having clarity on these foundational questions will help guide your decisions as you build your business.

Step 2: Choose a Business Structure

You’ll need to establish a legal business entity before you can officially open your doors. The most common options for therapists include:

  • Sole Proprietorship – The simplest option, but it doesn’t offer liability protection.

  • LLC (Limited Liability Company) – Offers liability protection and flexibility.

  • PLLC (Professional Limited Liability Company) – Required in some states for licensed professionals.

  • S-Corp – A more complex structure that may provide tax benefits for higher-earning practices.

Consult with an accountant or attorney to determine the best fit for your business goals.

Step 3: Get Your Business Paperwork in Order

Every private practice needs certain legal and financial elements in place, including:

  • EIN (Employer Identification Number) – Needed for tax purposes and opening a business bank account.

  • Business License & Registration – Check your state and local requirements.

  • Malpractice Insurance – Essential for protecting yourself and your practice.

  • NPI (National Provider Identifier) Number – Required if you plan to bill insurance.

  • Business Bank Account – Keep your personal and business finances separate.

Step 4: Choose an EHR and Set Up Your Admin Systems

A strong foundation of organized systems will save you countless headaches down the road. The most important tool for any therapist in private practice is an electronic health record (EHR) system, which streamlines client documentation, scheduling, and billing. Popular options include:

  • SimplePractice

  • TherapyNotes

  • Sessions Health

I’ve personally used four major EHRs, and my recommendation is Sessions Health, for cost, functionality, and features. You can use my link to get a discount.

Other essential systems include:

  • HIPAA-compliant email and phone services

  • A secure way to store client paperwork

  • A process for handling insurance billing or superbills

Step 5: Set Your Fees & Decide on Insurance Panels

If you’re offering private pay services, research local market rates to set a competitive but sustainable fee. If you’re accepting insurance, you’ll need to go through the credentialing process with insurance companies. While this can take several months, it can also help you attract more clients.

Not sure which route to take? A hybrid model—where you accept some insurance but also see private pay clients—can be a great option.

Step 6: Build Your Online Presence

Your online presence is critical for attracting clients. Here’s what you need:

  • A professional website – Your website should clearly state who you help, how you help them, and how clients can book a session.

  • A strong therapist directory profile – Psychology Today, TherapyDen, and similar directories can help potential clients find you.

  • Google Business Profile – This boosts your local SEO and helps people in your area discover your services.

  • Social media presence (optional) – While not required, platforms like Instagram, Facebook, or LinkedIn can help you connect with potential clients and referral sources.

Step 7: Start Networking and Marketing Your Practice

Referrals are one of the best ways to grow your private practice. Here’s how to get started:

  • Connect with other therapists for referrals.

  • Reach out to doctors, schools, and community organizations.

  • Join therapist networking groups online and in person.

  • Offer free workshops or psychoeducational content to build credibility.

Step 8: Set Healthy Boundaries & Business Policies

Many new therapists in private practice struggle with setting boundaries. Be sure to create clear policies for:

  • Cancellation and no-show fees

  • Client communication (email, phone, text)

  • Work hours and availability

Having these boundaries in place will protect your time and prevent burnout.

You Don’t Have to Do This Alone

Starting a private practice is a big step, but it doesn’t have to be overwhelming. By following these steps and taking it one piece at a time, you can build a thriving practice that aligns with your values and goals.

If you need help navigating the process—whether it’s choosing an EHR, understanding insurance billing, or marketing your practice—I’m here to help! As a private practice consultant, I specialize in guiding therapists through every step of the journey. Contact me today to schedule a consultation and get the support you need to launch your practice with confidence.