Counseling Disclosure Statement

Counseling disclosure statement

Professional Work: In my private practice, I offer teletherapy to those with cancer or other serious illnesses; relationship problems; and life transitions. My regular fee is $165 per session, and I offer a sliding scale, generally to $125. I also offer 30-minute sessions. In my work with Unite for HER, I offer teletherapy to people who have been diagnosed with breast or ovarian cancer. The service is free for people in the program who hold an active Unite for HER passport.

Education and background: I graduated from Immaculata University in Pennsylvania with a master’s degree in counseling psychology and began my private practice in 2007. I taught psychology at Delaware County Community College from 2010 – 2013. In 2018, I received my license as a professional counselor in PA. I am a nationally certified counselor (NCC). I have received training in holistic approaches, including hypnotherapy, energy psychology and EFT; and relationship counseling, including Gottman Level 1. I began working with Unite for HER as a provider in 2013 and joined the staff as Staff Counselor in 2021. I am on the board and serve as chair of the research committee of the Association of Comprehensive Energy Psychology. I am a member of the PA chapter of the American Counseling Association and serve on the government affairs committee. I am a member of the National Board of Certified Counselors and the American Counseling Association.

Licensure: See bottom of page for license number by state.

Degrees: Master of Arts in Counseling Psychology, Immaculata University, Immaculata Pennsylvania, awarded 8/2007. Undergraduate degree from the University of Maryland, College Park, 1991.

Confidentiality: Our work is confidential with the following exceptions: 1. Threat of serious harm to self or others. 2. Reasonable suspicion of child abuse, or neglect of a child, or abuse, neglect or exploitation of an incapacitated or dependent adult; 3. Court order; 4. Voluntary release signed by client or guardian; and 5. During supervisory consultations.

Areas of competence: I am trained for work with individuals and couples. I work with adults. I have advanced training in couples counseling, trauma therapy, and health issues.

Course of Action: Our first session is devoted to client history and goal setting. These goals may change during our work. I can use DSM or ICD10 diagnostic categories but generally do not focus on disease-model diagnoses. I use a whole-person framework that focuses on strengths and skill-building.

Fee schedule: Rates in 2022 are $165 for an hour session. All sessions are self-pay, online by credit card or electronic payment (PayPal). For those in the Unite for HER passport program, you may use your passport to work with me. One session = one square. Upon completion of the passport, I offer a reduced fee of $125 per 60-minute session, or $65 for half-hour sessions. I can reduce the fee further at times. See below.

Fee modifications: I offer a sliding fee scale for a limited number of clients. Please inquire if you would like more information.

Good Faith Estimate: I am required to provide you with a good faith estimate. You will receive that in a separate email.

Insurance: I am not in network with insurers. If your insurer covers out-of-network mental health services, I can provide you with a receipt for reimbursement upon request. Requests may be granted monthly or quarterly.

Accountability and Complaints: The practice of counseling is regulated by state boards which are authorized by law to discipline counselors who violate the board’s law or rules. To learn about the complaint process, or to file a complaint against a counselor, contact the appropriate state agency, listed below.

License information and board contact information by state

State License Type License Number Issue Date Expiration Date Board Contact Information
AR LPC 9401 8/17/2021 8/17/2022 Arkansas Board of Examiners in Counseling
CO LPC LPC.0017334 7/14/2021 8/31/2023 Colorado Department of Regulatory Agencies
FL LMHC telehealth provider # 861 Florida Department of Health
GA LPC LPC012452 10/12/2021 9/30/2022 Georgia Board of Professional Licensing
MD LCPC Maryland Board of Professional Counselors
ME LPC Pending Complaint Coordinator Office of Professional and Occupational Regulation 35 State House Station Augusta, ME 04333 (207) 624-8660 Web: www.maine.gov/professionallicensing
MI LPC Pending Michigan Department of Licensing and Regulatory Affairs
MO LPC Pending Missouri Division of Professional Registration
NC LPC MURP-FJ1E3K 07/13/2021 North Carolina Board of Licensed Clinical Mental Health Counselors
NJ LPC 37PC00811000 1/1/2022 11/30/2022 New Jersey Division of Consumer Affairs
OH LPC Pending Ohio Counselor Board
PA LPC PC010578 7/24/2018 2/28/2023 Pennsylvania Department of State
SC LPC Pending South Carolina Labor Licensing Regulation
TN LPC Pending Tennessee Department of Health
VA LPC 701010795 9/3/2021 6/30/2022 Virginian Department of Health Professions
VT LCMHC 68.0134367 7/24/2021 1/31/2023 Vermont Office of Professional Regulation
WA LMHC Probationary License RCW 18.225.140 Washington State Department of Health

 

 

 

For clients in Colorado only: Colorado law stipulates that professional counselors share the following information with their prospective clients. Below are the requirements for various mental health professionals in Colorado:

  • A Registered Psychotherapist is a psychotherapist listed in the State’s database and is authorized by law to practice psychotherapy in Colorado, but is not licensed by the state and is not required to satisfy any standardized educational or testing requirements to obtain a registration from the state.
  • A Certified Addiction Counselor I (CAC I) must be a high school graduate or equivalent, complete required training hours and 1,000 hours of supervised experience.
  • A Certified Addiction Counselor II (CAC II) must be a high school graduate or equivalent, complete the CAC I requirements, and obtain additional required training hours, 2,000 additional hours of supervised experience, and pass a national exam.
  • A Certified Addiction Counselor III (CAC III) must have a bachelor’s degree in behavioral health, complete CAC II requirements, and complete additional required training hours, 2,000 additional hours of supervised experience, and pass a national exam.
  • A Licensed Addiction Counselor must have a clinical master’s degree, meet the CAC III requirements, and pass a national exam.
  • A Licensed Social Worker must hold a master’s degree from a graduate school of social work and pass an examination in social work.
  • A Licensed Clinical Social Worker must hold a master’s or doctorate degree from a graduate school of social work, have practiced as a social worker for at least two years, and pass an examination in social work.
  • A Psychologist Candidate, a Marriage and Family Therapist Candidate, and a Licensed Professional Counselor Candidate must hold the necessary licensing degree and be in the process of completing the required supervision for licensure.
  • A Licensed Marriage and Family Therapist must hold a master’s or doctoral degree in marriage and family counseling, have at least two years post-master’s or one year post-doctoral practice, and pass an exam in marriage and family therapy.
  • A Licensed Professional Counselor must hold a master’s or doctoral degree in professional counseling, have at least two years post-master’s or one year postdoctoral practice, and pass an exam in in professional counseling.
  • A Licensed Psychologist must hold a doctorate degree in psychology, have one year of post-doctoral supervision, and pass an examination in psychology.