General FAQs

  • Yes, my practice is 100% remote (i.e., teletherapy). I do not offer in-person therapy. Research has demonstrated telehealth can be as effective as in-person therapy. Telehealth also confers additional advantages such allowing for greater geographical reach and increased flexibility in terms of scheduling (i.e., eliminates commute time and cost). Read more: Online Therapy.

    My online counseling platform uses secure video conferencing to enable face-to-face conversations. The video call is completely secure (HIPAA-protected) and confidential, and nothing is recorded or kept in any way. The video platform is also available on an app, so you can use your tablet or smartphone to connect.

    All you need is a device and an internet connection, as well as a quiet and well-lit space with no distractions. A set of headphones or earbuds will improve the audio.

    I am able to offer teletherapy services for teens, and adults in Oregon, Nevada, California, and all PSYPACT states (AL, AZ, CO, CT, DE, DC, FL, GA, ID, IL, IN, KS, KY, ME, MD, MI, MN, MO, MS, ND, NE, NH, NJ, NC, OH, OK, RI, PA, SC, SD, TN, TX, UT, VA, VT, WA, WV, WI, & WY).

  • General onboarding process: After receiving your inquiry form or a phone call at (702) 530-6134, I will email you or call you to chat for 10-15 minutes so that we can determine together if I am a good fit for your needs. The consultation also allows us to clarify any questions or logistical matters before becoming an official client.

    Scheduling: You may also schedule a 15-minute video consultation directly through my website (which helps us avoid playing phone tag).

    Paperwork: If we determine that we are a good fit, then we will find an available appointment time that might work for you on an ongoing basis (typically weekly). You’ll also be invited to complete the intake and consent forms in the client portal. These are all digital and don’t require printing or emailing. Before your first appointment (and every appointment after that), you’ll receive an email with a link to our video session.

  • Session #1 & (Maybe) #2: I will gather information from you about what problems you are facing and what you’d like to get out of therapy. By the end, I will tell you how I conceptualize your situation and what I think I can offer you.

    Subsequent Sessions: you’ll share the problem areas to be worked on and I’ll use my knowledge to help you make the changes you want to make. We will periodically examine whether we are following a path that is helpful for you.

    Depending on your reasons for seeking therapy, I will teach many concepts in-vivo so that you can integrate them. This means we will do the exercises in the session, not just learn about them. It might feel awkward at first, but like everything in life, we must step outside of our comfort zone if we want to improve our lives. We will also identify various exercises and goals for you to work toward outside of therapy.

    Read: How To Get The Most From Therapy.

  • Appointments are scheduled on:

    • Monday through Wednesday from 8 a.m. to 12 p.m. and 1 p.m. to 7 p.m. (PST).

    • Thursday from 8 a.m. to 12 p.m. and 1 p.m. to 6 p.m. (PST).

    You can view my current availability when requesting an appointment or consultation through the client portal. Please note that I may have waitlist for client using Aetna in-network benefits.

  • Almost everything is considered confidential in therapy. You may disclose a wide range of behaviors (e.g., illicit substance abuse, past crimes, etc.), and, generally speaking, mental health providers are not allowed to disclose anything to other people, including police.

    Can a therapist break confidentiality? If so, when is it considered appropriate to break it?
    Only under specific circumstances can a therapist break confidentiality. The main limits of confidentiality include:

    • Intent to die by suicide: For example, if a client is preparing or planning to kill themselves or is otherwise unable to assure the therapist that the client can keep themselves alive. In such cases, the therapist must break confidentiality such as by contacting emergency services, in order to ensure the client's safety.

    • Intent to harm or kill others: If the therapist is made aware of an identifiable person(s) that the client intends to harm or kill, confidentiality must be broken to ensure the safety of others.

    • Abuse or neglect of vulnerable populations: Confidentiality must be broken to ensure the safety of vulnerable populations (e.g., people with disabilities, minors, elderly people, etc.) in cases of abuse or neglect.

    • When mandated by a court or judge: Usually, clients will know if they are involved in these types of legal proceedings.

    There are also state-specific laws that govern when someone can break confidentiality. For example, in Washington State, a therapist must also break confidentiality if they learn from you that another medical or mental health professional is performing their job incompetently or unethically. In Nevada, there is a statute that confidentiality can be broken if a client is going to seriously "mutilate" themself.

    Other areas where confidentiality can be broken include purposes of treatment and referral to other health professionals and billing purposes (e.g., insurance, collections).

  • For many of my clients, therapy typically begins with one appointment, each week for 3 to 6 months. Regular weekly sessions, particularly in the early stages of therapy, have been associated with improved outcomes, as consistent engagement helps in building therapeutic momentum and addressing issues more effectively (Erekson et al., 2015). Certain treatments, such as those for OCD, benefit from sessions twice a week to achieve faster progress (Foa et al., 2012). Depending on your reasons for seeking therapy, your goals, and the progress you have made, we might decide to switch to shorter appointments (e.g., 30 minutes) or spaced-out appointments (e.g., every 2 weeks). I only want to keep you in therapy as long as you feel that you are gaining value from it or are making progress toward your goals.

    Other people may seek therapy for personal growth reasons or assistance in navigating life transitions and may wish to continue individual therapy for longer periods of time.

    I will check in periodically to ensure you are still getting what you need out of therapy and making progress toward goals. If you are, then great! If not, then great (because that could mean you have made a lot of progress already). If you feel therapy isn’t working for you, then I will make referrals or other recommendations as appropriate.

  • International therapy: On a case-by-case basis, I can work with clients living in or visiting Ireland, India, Iran, Japan, Kenya, Kuwait, Nigeria, Pakistan, the Philippines, Poland, Russia, Singapore, Thailand and Turkey.

 Payment FAQs

  • Standard Rates:

    • 45-minute session: $250

    • 30-minute session: $190

    • Initial evaluation session with family (90-minutes): $385

    • WPATH GEI mentoring: $165 / hour

    If you choose not to submit reimbursement claims directly to your insurance yourself, I have partnered with Thrizer, which will file claims on your behalf. Read more on the Rates page.

  • I no longer accepting new client’s as an in-network provider. However, many insurance plans may reimburse part of your therapy expenses if you have eligible Out-of-Network (OON) coverage for behavioral or mental health. Some insurance plans reimburse a large portion of the fee, and some do not. You can use the out-of-network benefit estimate tool on the fees page to get an estimate of your OON benefits and learn more about how it works. Ultimately, however, to determine if you have mental health coverage, you should check with your insurance carrier.

    Check your coverage carefully and find the answers to the following questions:

    • What are my mental health benefits?

    • What is the coverage amount per therapy session?

    • How many therapy sessions does my plan cover?

    • How much does my insurance pay for an out-of-network provider?

    Confirm your network status and coverage of services provided through telehealth/teletherapy. Specify the service code(s): 90791, 90834 will be through a secure video platform. Click here for a guide on checking OON benefits.

    I use Thrizer to simplify reimbursement, allowing you to pay just your co-pay upfront. If you prefer not to use Thrizer, then, by default, I provide monthly “superbills” for you to seek reimbursement directly (provided you have eligible benefits).

    Note: Insurance reimbursement is often contingent on receiving a medical or mental health diagnosis and certain diagnoses may not qualify. I do not accept responsibility for collecting payment from your insurance company and cannot guarantee that you will be reimbursed or that you will qualify for a reimbursable diagnosis. When you use insurance to help pay for counseling services, they require that I assign you a diagnosis code and then provide them with this information. Having certain mental health diagnoses may interfere with obtaining some forms of employment (e.g., jobs that require security clearance) or being able to obtain some types of insurance such as health, disability, or life insurance.

  • Assuming you met your deductible, here is an EXAMPLE of how your OON coverage may work:

    • Suppose that your therapist has a Standard Fee of $250/session and is an OON provider (like me).

    • Also suppose that your insurance company has an Allowed Fee of $180 and that they cover 80% of the allowed fee.

    • You would therefore have a copay of $36 (20% of the $180 Allowed Fee) and a remaining fee of $70 (The difference between the "Standard Fee" & the "Allowed Fee"), meaning that you pay $106/session and your insurance pays $144/session.

    You would pay the full fee ($250) for each session and then submit a reimbursement form (usually online or you can do this through Thrizer) to your insurance company with information from the superbill I provide. Most people find it manageable to submit reimbursement claims to their insurance once every 1 to 2 months. The figures in the example are dependent on the details of your specific insurance plan. If you are unsure what your OON benefits are, this guide can help you. You can also read more and use the OON estimate tool.

    Superbills are automatically generated on the 3rd of every month. Your superbill will be located in your client portal under the “Billing & Payment’s” tab.

    As a solo practitioner, I cannot accept most insurance plans for therapy. The primary reason is that the low reimbursement rates do not accurately reflect the true cost of providing quality care. The overwhelming administrative tasks required for insurance billing consume valuable time that could be better spent on patient care. Additionally, the risk of insurance companies demanding repayment for sessions, sometimes years after they have occurred, introduces financial instability. Faced with these challenges, especially as a solo practitioner, I prioritize direct care over navigating insurance complexities, ensuring my focus remains on delivering the highest standard of therapy.

    How does Thrizer help with out-of-network reimbursement?

    I've partnered with Thrizer to simplify the reimbursement process. They handle claim submissions on your behalf, ensuring accuracy and efficiency.

    • Thrizer Pay: Pay just your co-pay upfront, and Thrizer bills your insurance for the rest. There's a 5% fee on your co-pay for this convenience.

    • Reimbursement: Pay the full session fee and submit claims yourself through your insurance directly (free) or use Thrizer for reimbursement (1% fee).

    I would be an "outside provider" or "non-participating" on your plan and you will be responsible for paying for each session in full at the time of appointment (if you prefer not to use Thrizer pay in order to only pay your co-pay up front). If you choose to file directly with your insurer (and not use Thrizer), I provide you with a receipt called a “Superbill” that you can submit to your insurer for reimbursement (provided you have eligible OON benefits). It typically takes insurance three to six weeks to process your claims.

  • Thrizer Pay (Out-of-Network): Most important, we first check to confirm you have OON benefits and learn what they include. From there, if you do have benefits you want to take advantage of, we will use Thrizer for billing each session and you can choose to only pay for your co-payment or to seek reimbursement for the full session rate that you pay upfront.

    Out-of-Network: Credit card information is collected via a secure platform prior to our first session. Between 12:00 - 2:00 AM the day after our appointment, the credit card on file will be charged. If you have eligible out-of-network benefits, you will be provided a "superbill" on the 3rd of every month, which contains all the necessary to seek reimbursement through your insurance company.

  • Please note that as a solo practitioner, I have a cancellation policy in place to ensure the smooth functioning of my practice and provide the best possible care to all my clients.

    To allow for proper scheduling and accommodate others who may be in need of my services, I kindly request at least 24 hours' notice if you need to cancel or reschedule your appointment. For non-emergency cancellations or rescheduling requests made with less than 24 hours' notice, a cancellation fee equal to the cost of the scheduled session will be applied. Insurance (whether in-network or out-of-network) does not reimburse for the cost of late cancellations or missed appointments.

    This cancellation fee, equal to the session price, is implemented to respect my time and expertise, ensure fairness to both of us, encourage commitment to therapy, and maintain a sustainable practice. Your scheduled appointments are reserved only for you and a cancellation made on short notice deprives me of the opportunity to fill that time slot with another client who may be in need of assistance.

    If you are an existing client, you can cancel, reschedule, or request new appointments through the client portal if the request is made at least 24 hours prior to the scheduled appointment time.

    Thank you for your understanding and cooperation. If you have any questions or concerns, please feel free to discuss them with me.

  • I offer 7 sliding scale slots ranging from $150 to $200. These slots are based on financial need and are first-come, first-serve. These sliding scale slots are also intended for uninsured clients, clients with no out-of-network benefits, or clients with other financial difficulties in accessing therapy services. Please note that clients utilizing the sliding scale fee typically have their therapy sessions limited to 10 to 18 sessions, ensuring that I can accommodate as many clients as possible while maintaining the quality of care.