Become A Member
1 Year Professional Membership Registration = $100
* Required items if you would like your professional information listed on the BPGNY website
*First Name:
*Last Name
*Preferred Email address:
*Phone Number
*Practice Address:
*Academic Affiliation and Position: (if any)
*Practice Payment options:
(e.g., check, credit card)
*Insurance(s) accepted (if any):
*State in which You are Licensed to Practice:
*State License Number:
*Degree(s): (e.g., MD, PhD, LCSW):
*Clients served: (Select one)

*Preferred Method of Patient Contact: (e.g., phone, email):
Borough: (Select One):

Website: (if any)
Practice Name: (if any)
Title: (Select one)
Description of Services Provided (maximum of 200 words): Narrative paragraph describing your experience/relevant training, any specialty areas, other work interests, the kinds of referrals you are interested in receiving, your professional affiliations, and whatever else you would like to share about your professional life.

Do you want your professional / practice information listed on the BPGNY wbesite?
To add a professional photograph of yourself for the BPGNY website, email it here.


Proof of current state licensure and confirmation of dues payment are required before your practice information will be posted on the BPGNY website. You will be contacted by a BPGNY administrator when licensure and payment are confirmed.

Pay Dues To pay membership dues for BPGNY online, click on the "Subscribe" link below. You will be directed to the Social Service Board, United Social Services Inc. website where you can pay through PayPal.

Alternatively, you can write a check / money order made payable to United Social Services, Inc. In the Memo section of your check / money order, please write "BPGNY Membership".

Please mail check / money order to: United Social Services, Inc. and mail to:

Black Psychiatrists of Greater New York & Associates
c/o United Social Services, Inc.
2 West 64th Street Rm. 505
New York, New York 10023

For questions about membership, send an email to
BPGNY & Associates
c/o United Social Services, Inc.
2 West 64th Street, #505
New York, NY 10023
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