Contact

Am I The Right Counselor For You?

Feel free to use the contact form on this page to see whether I’m the therapist you’re looking for. If you’re not a fan of contact forms, feel free to call, email, or text using the information listed below. If using email or text, please do not include any sensitive information. We can cover any private information over a secure teleconference or phone call.

I’ll get in touch with you soon. I look forward to connecting with you!

Email:

matt@mattkernicky.com

Phone/Text:

717.298.0875

Mailing Address:

Mailing Address Only
848 E Main Street
Suite 800 #1028
Ephrata, PA 17522

Name

First Name

Last Name

Why are you interested in counseling services?

What would you like to change or work on? If you have private information that you'd hesitate to include in an unsecured email message, please leave this blank. We can discuss your concerns during the consultation.

How did you hear about me?

Do you have any other questions for me?

Note that email and text messages can sometimes be seen by others. If you have anything sensitive or private to share, please call using the phone number listed on this page. If you are an existing client, you can message me privately through the web portal. By completing this form and clicking on the Send button below, you agree to the terms outlined above.

Contact

Am I The Right Counselor For You?

Email:

Phone/Text:

Mailing Address:

Thank You!