SUPERVISION AGREMENTNevada • January 9th, 2021
Jurisdiction FiledJanuary 9th, 2021Counselor Intern’s Name (Print or Type) Address Supervisor’s Name (Print or Type) Credential (CADC, LADC, LCADC) License # Co-Supervisor’s Name Credential (CADC, LADC, LCADC) License # Organization Phone AddressARTICLE I Parties City State Zip