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Become a Member

Outstanding Client Service
Great Pricing
Free Membership
Proprietary Online System
Only Appropriately Licensed Clinicians Are Eligible For Membership

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Please click HERE if you have already started an application.

Click HERE to see if you are already a member of Professional Co-op Services.

Our service is not available in NY, NJ, or RI.
Only clinicians who reside and are licensed in MA may use services in MA.

CLINICIAN INFORMATION

STEP 1 OF 3

All accounts must be entered in the name of the ordering clinician only.

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LICENSEE INFORMATION:

First*

Last*

E-mail*

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Phone*

Fax

Professional Designation*

Office Contact

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ADDRESS INFORMATION:

Office Address

Street Address*

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Suite

City*

State*

Zip*

Mailing Address

SAME AS OFFICE

Yes

Street Address

PO BOX IS ACCEPTABLE

Suite

City

State

Zip

If you do not see your state listed, please contact Professional Co-op® at 866-999-4041

RETURNING MEMBER:

Are you a returning or existing member of Professional Co-op Services, Inc.?

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CLINICIAN LICENSE:

License #*

License State*

NPI*

Your input must be 10 numeric digits.

Our staff will attempt to verify your license. If we are unable to access your license online we will contact you.
If you do not see your state listed, please contact Professional Co-op®

PCS reserves the rights to reject any application and to terminate membership at will.

The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.

To protect the integrity of your data and the privacy of your patients, all data is handled in
accordance with HIPAA guidelines and protected by 256-bit AES encryption.

2700 N 29th Ave., Suite 308, Hollywood, FL 33020 T: 866.999.4041 | F: 866.999.9175 | E: This email address is being protected from spambots. You need JavaScript enabled to view it.

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