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Build a Therapy Business in 4 steps: Part I & II

S&E Consulting · March 25, 2026
Build a Therapy Business in 4 steps: Part I & II

Part 1: The Foundation – The S-Corp Sweet Spot

Running a successful LLC is great until you look at your self-employment tax bill and want to cry into your coffee. Once your practice starts netting around $75,000 to $80,000 a year, it’s time to look at an S-Corp election.

  1. The Magic Loophole (That is Completely Legal): An S-Corp isn't a brand new business entity you have to build from scratch. It’s simply a tax status you elect with the IRS for your existing LLC.
  2. Paying Yourself: Instead of paying a 15.3% self-employment tax on all of your profits, an S-Corp allows you to put yourself on payroll with a "reasonable" W-2 salary. You then take the remaining profit as an owner's distribution, which bypasses that hefty self-employment tax.
  3. Oregon Red Tape: While the IRS handles the S-Corp election, remember that Oregon S-Corps still have to pay the state's minimum excise tax (currently $150 annually). Additionally, ensure your business structure and any assumed business names (DBAs) play nicely with the Oregon Board of Licensed Professional Counselors and Therapists (OBLPCT) regulations.

Part 2: The Team – Hiring Humans (Legally)

Unless you've figured out how to clone yourself, scaling means you eventually need to hire. This is where you go from a solo act to a thriving group practice.

  1. W-2s vs. 1099s: The temptation to hire 1099 independent contractors is strong because it feels easier on the paperwork front. However, Oregon’s Bureau of Labor & Industries (BOLI) applies strict "economic realities" tests. If you want to control the clinical standards of your brand, require specific training, or dictate schedules, you need to hire W-2 employees.
  2. Mentoring the Next Generation: Bringing on Counselor Associates is a brilliant growth strategy. You get to mold fantastic clinicians, provide excellent supervision, and build deep loyalty, all while rapidly expanding your practice's capacity to take on new clients.
  3. The Payroll Reality: Having W-2s means setting up formal payroll to handle Oregon state tax withholding, Workers' Compensation insurance, and Paid Leave Oregon contributions. Platforms like Gusto can make this highly automated.

Verified Sources for Article 1:

  1. IRS Instructions for Form 2553 (S-Corp Election): https://www.irs.gov/pub/irs-pdf/i2553.pdf
  2. Oregon Department of Revenue (Corporation Minimum Excise Tax): https://www.oregon.gov/dor/programs/businesses/pages/corp-requirements.aspx
  3. Oregon BOLI (Employee vs. Independent Contractor): https://www.oregon.gov/boli/employers/pages/employee-or-independent-contractor.aspx
  4. OBLPCT Code of Ethics and Administrative Rules: https://www.oregon.gov/oblpct/Documents/Former_Div.100.pdf


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