Quick Answer: Starting a private practice requires more than clinical training. You need a physical or virtual space, dedicated business systems, the right legal and financial structure, and software that keeps administrative work from consuming clinical time. This guide walks through all eight steps in the order they matter most.

Launching a private practice is one of the most significant professional transitions a clinician makes. The clinical training is already there. What is less familiar is everything else: the lease decisions, the business accounts, the insurance questions, the software choices. Each of those decisions shapes the practice you end up building.

Do them in the right order and the foundation is solid. Skip them or rush them and the administrative weight compounds quickly. For behavioral health clinicians, that weight has real consequences: research published in Healthcare in 2024 found that high caseloads, lack of control over administrative processes, and inadequate organizational support are among the leading contributors to burnout among psychotherapists (Tragantzopoulou & Giannouli, 2024). Building the right infrastructure from the start is not just a business decision. It is a sustainability one.

Here is what needs to be in place before your first client walks through the door.

Key Takeaways

Set up your physical or virtual space before committing to referral sources or marketing.
Separate your business and personal finances from day one. A business bank account and credit card are non-negotiable.
Hire an attorney and accountant early; the right business structure saves money and liability headaches later.
Malpractice insurance and liability coverage must be in place before you see a single client.
Your EHR choice affects clinical documentation, billing, and how much time you spend on administrative work. Evaluate it as carefully as you would any clinical tool.

Step 1: Find Your Space

You can’t book clients before you know where you will see them. That sounds obvious, but space decisions have downstream effects on commute, client demographics, and cost structure that are worth thinking through carefully before signing anything.

The main options are a part-time sublet (lower cost, good for starting out, but plan for a potential move as caseload grows), a full-time lease (more predictable, avoids a disruptive transition later), or a wellness co-work space (increasingly common, often includes amenities like waiting areas, soundproofing, and scheduling services built in).

Key questions to answer before deciding:

How close is it to your target client population? Mass transit access, residential proximity, and nearby referral sources all matter.
Is it genuinely quiet? Sound carries differently in different buildings. Walk through at peak hours before committing.
Is client privacy protected? Clients should be able to arrive and leave without feeling visible.
Does it allow for professional growth, or will you outgrow it in six months?

If you are exclusively teletherapy from the start, this step shifts to setting up a HIPAA-compliant home workspace. The privacy and soundproofing considerations still apply.

*Private practice therapy office setup with comfortable seating and natural light*

Step 2: Set Up a Business Phone

Using a personal cell phone for client calls is common, especially at the start. It is also a boundary that erodes quickly. Weekend calls, late-night voicemails, and the inability to fully step away from the practice are predictable consequences.

The practical options range from a dedicated business cell phone (the most flexible) to a forwarding service like Google Voice or Grasshopper (lower cost, widely used among therapists). A call center or virtual assistant is worth considering as volume grows; some can access your calendar to schedule intakes and handle intake calls directly.

Whatever you choose, your outgoing message should include state-required crisis line information and clear instructions for reaching you in an emergency. Check with your licensing board on any specific requirements for your profession and state.

Step 3: Build Your Website and Professional Email

Your website is how referral sources and prospective clients find you, learn about your approach, and decide whether to reach out. It needs to be live before you start marketing your practice.

At minimum, your site should include your credentials and training, clinical approach and populations served, office location and contact information, and a clear call to action (typically a contact form or phone number). A professional email address (using your domain rather than a personal Gmail) reinforces credibility with referral sources and signals that this is an established practice.

Include your title, degree, and contact information in your email signature. It does more work than you might expect.

Step 4: Hire the Right Professional Help

Running a practice means running a business. There are things a skilled clinician does well and things that genuinely require someone else.

Attorney

Client contracts, HIPAA forms, and consent documents need to be legally sound. If you hire employees or contractors as you grow, labor law questions follow. An attorney who works with healthcare providers is worth the investment early.

Accountant

Business structure, quarterly taxes, deductions are all decisions with long-term implications. An accountant who understands small healthcare practices will pay for themselves many times over in the first year alone.

Marketing Support (Optional but Worth Considering)

You can manage a Psychology Today listing and basic social presence yourself. Paid advertising is a different matter. If you run your own Google Ads campaign without understanding how it works, the cost-per-acquisition math can go wrong quickly. Whether you manage it or hire someone, track your return on investment and know your client acquisition cost.

Step 5: Choose Your Business Structure

This is the decision your accountant and attorney should guide you through, not one to make based on what a colleague chose. The right structure depends on your profession, state, number of owners, and the services you offer.

Common structures for solo behavioral health practices include LLC, PLLC, S-Corp, and Professional Corporation (PC). Each carries different implications for liability protection, taxation, and how you pay yourself. Get professional advice here before filing anything.

Step 6: Open a Business Bank Account and Credit Card

Every business transaction, such as client payments, vendor checks, or software subscriptions, should flow through a dedicated business account. Mixing personal and business finances creates accounting headaches at tax time and can complicate liability protection depending on your structure.

A business credit card helps build business credit and makes expense tracking cleaner. The interest rate on a business checking account is often minimal, but the organizational clarity is worth it from the start.

Step 7: Get Your Insurance in Order

Two types of insurance are required before you see clients, with a third that is frequently overlooked.

Malpractice insurance: If you do not already have coverage, secure it immediately. Do not see clients without it.
General liability insurance: Depending on your lease, your landlord may require it. It covers incidents in your office space (a client fall, for example) that malpractice insurance does not.
Health insurance: If you are leaving an employed position, coverage typically ends at termination. Research plans before your start date; this process takes longer than most clinicians expect.

An insurance broker can present multiple plans across all three categories and explain coverage and cost structures. There is no obligation to purchase, and the time savings alone make the conversation worth having.

Step 8: Choose Your Software

The right practice management software is the infrastructure everything else runs on. For most behavioral health practices, that means an electronic health record (EHR) that handles clinical documentation, billing, and scheduling in a single system.

A good EHR should reduce administrative overhead, not create it. For a solo practitioner without billing staff, the efficiency of your claims workflow directly affects your cash flow. The clarity of your documentation tools affects your clinical work. These are not secondary considerations.

Key things to evaluate in any EHR trial:

How many steps does it take to go from a completed session note to a submitted claim?
Is billing integrated natively, or does it require a separate clearinghouse login?
Are documentation templates built around behavioral health CPT codes and note formats?
Is there a mobile app that supports your workflow away from your desk?
What does onboarding and ongoing support look like?

My Best Practice was built specifically for behavioral health clinicians. It combines documentation, integrated billing, telehealth, and scheduling in one HIPAA-compliant platform, with AI Notes to reduce end-of-day documentation load and a White Glove Migration for practices switching from another system. See What Makes a Good EHR for a deeper look at what to evaluate, or start your free trial to run through a realistic workflow before committing.

'Behavioral health clinician using My Best Practice EHR in private practice office — *Behavioral health clinician using My Best Practice EHR in private practice office*

One More Thing: Know Your Caseload Goals Before You Market

Before you start accepting referrals, get clear on what you are building toward. How many clients do you want to see per week? Who are they? What populations, presentations, and payer mix? Will you accept insurance, operate out-of-network, or use a hybrid model?

These answers shape your fee structure, your marketing, your credentialing decisions, and whether your practice is financially sustainable from the start. A realistic weekly caseload target, accounting for cancellations, vacations, and holidays, is typically closer to 45 working weeks per year. Build in that math before you build your schedule.

Building Your Practice? Start With the Right EHR.

My Best Practice gives behavioral health clinicians a complete platform for documentation, billing, and telehealth,
with no credit card required to start.

Start your 14 day trial

References

Tragantzopoulou, P., & Giannouli, V. (2024). Burnout and coping strategies in integrative psychotherapists: Findings from qualitative interviews. Healthcare, 12(18), 1820. https://doi.org/10.3390/healthcare12181820

U.S. Health Resources and Services Administration. (2025). State of the behavioral health workforce, 2025. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/Behavioral-Health-Workforce-Brief-2025.pdf

This content is intended for licensed behavioral health professionals considering or actively building a private practice.