Frequently Asked Questions
Integrative Psychiatry and Psychotherapy
My philosophy: By nature things ebb and flow. I work with you to find meaning and balance.
Our work together is a partnership. We achieve long-term results, not just symptom reduction. Together we address all your mental health needs in one place – prescribing, therapy, lifestyle, nutrition, complementary medicine approaches and more.
My practice model: This practice is designed to offer the deepest, most thoughtful and effective care possible.
As a small private practice, you receive my full attention. I think about you between appointments. I research the latest treatment options relevant for you. In a direct-care practice, you have no insurance middleman dictating care. Instead I have an honest, upfront fee structure including no surprise administration charges. I offer long appointments, quick check-ins and everything in between with little to no wait time. You have direct access to me. With virtual appointments, you have convenience and privacy.
The intangibles: I am human with you.
I bring dedication, compassion, authenticity and curiosity. I will probably crack some jokes. I will definitely care about you. Because of my extensive training I bring a sharp clinical acumen that crosses disciplines. This expertise eases your path to healing.
It is an approach that incorporates both conventional psychiatric treatments (medications, therapy) and evidence-based complementary/alternative treatments (nutrition, mind-body-spirit practices, supplementation, botanicals etc). It aims to understand and address all aspects of a person – mind, body and spirit. It is the most comprehensive and personalized form of psychiatry and because of that it provides the most meaningful and long-lasting results.
Both providers may play a role in helping your mental health. They both prescribe medications and provide psychotherapy. They differ significantly in depth of training (20,000 hours vs 1,000 hours) and supervision requirements (which vary by state). Check out the chart below to learn more.
| Psychiatrist | Psychiatric Nurse practitioner |
Degree | MD, DO | PMHNP-BC |
Average years of formal education | 12 years
| 6 years
|
Minimum hours of clinical training | 20,000 hours | 1,000 hours |
Residency (advanced mental health clinical training) | Required (4 years) | Not required |
Require supervision to practice | No (can supervise others) | Usually yes (depends on state) |
All these professionals are licensed to provide therapy, but only a psychiatrist prescribes medications. The extent of training in mental health and type of degree varies. Below are the minimum years of mental health specific training for professionals who provide psychotherapy:
- Psychologist (PhD) – 6 years
- Psychologist (PsyD) – 5 years
- Licensed professional counselor (LPC) – 2 years
- Licensed Clinical Social worker (LCSW)– 2 years
- Licensed marriage and family therapist (LMFT) – 2 years
- National Certified Counselor (NCC) – 2 years
- Psychiatrist (MD or DO) – 8 years (including medical school) * also prescribes medications
- Psychiatric mental health nurse practitioner (PMHNP-BC) – 2 years * also prescribes medications (often under psychiatrist supervision)
Membership and Consultation Tracks
I see membership as a transparent commitment between you and me. Membership allows me to maintain a personal practice that with little to no wait time for appointments for you. It also means I reduce costly surprise charges for you. Other private practices often charge hundreds of dollars in hidden fees for things like lab review, documentation review, coordination of care with your other providers, quick check-ins, and administrative fees (eg filling out forms, documentation, prior authorizations). With direct-care membership, this is all included with no extra charge.
Membership means you join my practice and receive ongoing care from me which can include integrative psychiatry and/or psychotherapy. You do not need a psychiatrist, PCP or therapist to join. I treat patients with depression, anxiety, burn out, life transitions, trauma and have a particular specialization in women’s mental health, anti-depressant de-prescribing as well as psychodynamic therapy. There is a small monthly membership fee and per-service physician-contact fees.
Consultation means we have a one-time evaluation to review what holistic approaches you can take to optimize your current mental health treatment. You need to have a primary mental health provider (psychiatrist, PCP) who I can coordinate with. I work with patients with a wide variety of mental health concerns. There is a fee for the evaluation which includes care coordination. There is no membership fee. There is no on-going follow up care from me; you continue to follow with your psychiatrist or PCP.
Absolutely! I think it’s crucial that you continue to work with your trusted therapist or psychiatrist. I work collaboratively with all your healthcare providers.
- You have a psychiatrist:
- Consultation track: One-time consultation for recommendations on how to optimize your treatment in a holistic, integrative manner.
- Membership track: Become a member of my practice for psychotherapy.
- You have a therapist (but no psychiatrist):
- Membership track: Become a member of my practice and receive integrative psychiatry services without psychotherapy.
- Consultation track: One-time consultation for recommendations on how to optimize your treatment in a holistic, integrative manner. This requires you to have a PCP I can collaborate with.
No, for ongoing personalized care you need to be a practice member.
You can cancel at any time. Simply send me a message asking to end your membership. I cancel your monthly membership charge and any upcoming scheduled appointments as well as formally discharge you from my practice.
Deciding how to best address your mental health struggles is a tough and important decision. My practice approach for members requires commitment – financial, emotional and time – and focuses on holistically integrating modern psychiatry with alternative and complementary modalities. It’s how my patients get meaningful, lasting results. It’s also a style that doesn’t necessarily resonate with everyone. If you are open to it, I suggest setting up a no-commitment, free discovery call to learn more about my practice and what working together looks like.
Appointments
- They offer the same professional psychiatric care but from the comfort and privacy of your own space. You need access to a device that offers video and call capabilities as well as a private location (such as your home or an office space) where you feel comfortable talking.
- This model allows for more flexibility when scheduling, reduces risk of highly transmissible diseases like covid-19, decreases unexpected missed visits and eliminates commute and wait time hassles. It also increases access to services for people who might not live near me.
I offer a limited number of in-person appointments in Pittsburgh, Pennsylvania at this time.
This varies significantly depending on your treatment goals and level of distress you are in. Generally, members seeing me for psychotherapy (with or without integrative psychiatry) are seen 1-2 times per week. Members seeing me for just integrative psychiatry (not psychotherapy) are seen initially once every 1-2 weeks for the first 1-2 months and then less frequently as they improve. Patients who need less support are seen as infrequently as every 3-4 months.
Please note: we shape frequency and duration of appointments/check-ins to what works for you.
- If you are coming to see me, I often advise that you also do therapy. There are certainly exceptions to this but I’ve found that most patients can benefit from therapy even if they’ve tried it before and felt it hasn’t worked.
- At our initial evaluation, I discuss with you what types of therapy I think would be helpful for you. We discuss if you would like to do therapy with me and what that looks like. I can also provide referrals for other therapy providers.
Pricing
- The short answer is no. I do not accept insurance or participate in medicare or medicaid. The long answer I’m very passionate about: Insurance companies must make a profit and they do this by limiting access to certain treatments for patients.
- By working directly with you, your interests are prioritized. There is no insurance middleman in the way. I have to provide exceptional care (or else no one would come see me). We are able to have long appointment times as needed, establish a deep, personal connection and treat you holistically.
- I am able to provide you with ‘superbills’ for each appointment, which you submit to your insurance for reimbursement. Most insurances with out-of-network benefits cover 40-100% of my fees. You can also use a HSA or FSA. Monthly membership fees may or may not be covered by insurance. Please contact your insurance to determine how much they reimburse.
- When speaking with insurance it can be helpful to know the common billing codes I use (below), your out-of-network reimbursement rate, and your deductible. I walk you through any further questions you might during our initial discovery phone call:
My most common billing codes:
Initial Evaluation – 90792
Follow-Up – 99213 + 90833 (25 minute) or 99213 + 90836 (50 minute)
Monthly fee: You pay a $75 membership fee every month.
Per-service fee: Any talking with me for longer than 5-minutes via phone call, video call or in-person (whether it’s a scheduled appointment or not) incurs a physician-contact fee. The fee is based upon the amount of time spent talking or length of the scheduled appointment. If you don’t attend a scheduled appointment you are charged the full appointment fee. You are charged the same day we talk or are scheduled to meet.
No charge: Complimentary services include care coordination (communication with any of your medical, mental health or pharmacy providers), lab review, review of documentation or other records, documentation of your appointments, prior authorizations, sending refills, filling out forms, answering your messages/emails, coping of your records, and quick check-in phone calls shorter than 5 minutes.
I do not offer a sliding scale for my fees. If you are unable to afford my rates, I recommend searching for another provider. I know it is pretty daunting trying to find someone to help you. A couple of places you can try include: calling your insurance; they should give a list of providers who accept your insurance. Psychology today and zencare offer directories of providers whom you can search based upon location. Alternatively, your PCP or other healthcare providers may have recommendations.
I accept debit or credit cards. You have a card on file to receive care with me.
Services
I do not provide emotional support animal, disability, forensic or custody evaluations. I do not provide ADOS evaluations or neuropsychological testing. I do not prescribe controlled substances, provide medical marijuana cards or do ketamine therapy.
No, I do not prescribe controlled substances like xanax or adderall. Because I often practice virtually, under the Ryan-Haight Act I am legally unable to prescribe these medications.
- I do not work with patients who are so mentally ill they cannot care for themselves (eg not eating, bathing, taking life-sustaining medications), patients who have acute, active suicidal ideation with plan or homicidal ideation, patients recently discharged from psychiatric hospital without an intermediate level of care like a partial hospitalization program or intensive outpatient therapy. These patients require a higher level of care than I can provide.
- I do not work with children (under 18 years) or the geriatric population (older than 64 years). I am not specialty trained in these populations.
- I am unable to be the primary psychiatrist responsible for ongoing care for patients who require controlled substances (like xanax or adderall) nor patients who have a psychotic disorder or active eating disorder. I am able to provide a one-time consultation for these patients.
Yes! I believe that identity is a crucial part of mental health. I have worked at a LGBTQ+ mental health clinic providing me with clinical training in gender affirming care in a psychiatric context. I am able to write letters of support for gender affirming procedures. For some individuals understanding how their provider identifies is important; I identify as a cis heterosexual white female (she/her pronouns).
Office Policy
I’m so glad you asked! If you are interested in setting up a discovery call to learn more about my practice, please fill out the initial interest form. For providers looking to collaborate or refer patients, please contact me using this form.
If you are a member of my practice, you can call me, message me or set up an appointment to talk.
If you are currently experiencing a behavioral health emergency, please contact the crisis resources below before calling or messaging me. I may be with another client and unable to respond.
- Call 911 or 988
- Go to your nearest emergency room
- Contact your local mental health crisis support organization. Click for a list of local mental health resources.
I understand that life happens and sometimes you can’t make appointments. Please let me know as soon as possible; this allows me to open up the time slot for another patient. You can cancel or reschedule for any reason (just use the online portal) with no cancellation charge up to 24 hours before the appointment (with membership) or 48 hours before the appointment (for consultations). If you do not give the requested notice and can’t attend the appointment or you arrive significantly late, you are still charged the full cost of the scheduled session and may need to reschedule.
All of the systems I use are HIPAA compliant ensuring that all our communication and your information is safe and private.
Interested in working together?
6301 Forbes Ave, Suite 120
Pittsburgh, Pennsylvania 15217
Nature's Flow Psychiatry
7901 4th Street N, Suite 300
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