If you're planning on laying down roots in a locality, you're going to want to try to get a URL that incorporates your locality name, and a word that describes your service.
So I'm here in Seattle. If I had graduated with my Masters in 1996, I might have been able to jump on SeattleCounseling.com. Wow that would have been great. I graduated long after that and it was taken, and because in 2002 we were not really thinking about Search Engine Optimization, I got good ole ChangingForGood.com for my Seattle-based practice.
I think the locality word is obvious (if you are in a big city, this may mean a neighborhood, like SoHo - if you are in some states, it might mean a county name - just think how people search where you are).
The service word can vary a bit. If you are a counselor, therapist, or social worker, I would try to get "counseling". It is searched much more than "counselor". If you specialize in couples, couplescounseling or marriagecounseling are about even (I'd lean to marriage counseling, I think it includes couples, but not the other way around).
If I were a psychologist, I would go for that word (never, ever "psychology", though).
Definitely go for a .com address - please do not bother with .net, .org, .edu. .us, .info, .biz or any other (if you are in the US). It will just lead to confusion for people, and seems second class to the consumer.
So, there is a great chance that your primary domain choice will be taken (HoustonCounseling.com, for instance). Here are some other ways to go.....
PS - domain names are not case-sensitive. I add in capitals so you can see the words better (I do at in ads I place, too).