Good Faith Estimate of Client Costs
Oh, That’s Why! Therapy and Assessments
Provider Information
Samantha McCann, LMHC
NPI 1700521127
EIN:
Estimated Cost of Services Provided
The cost of the initial 55 minute intake session is $225.00
The cost of each 55 minute clinical session is $200.00
The cost of each Neurotype Consultation Session is $250.00
The cost of each Sensory Profile is $500.00
The cost of a Comprehensive Evaluation is $3000.00
The cost of each additional assessment/feedback session is $250.00
Diagnosis (when applicable)
I am not able to propose an appropriate diagnosis or course of treatment for you until we have spent some time together. As soon as we are able to identify a diagnosis and an appropriate course of treatment, I will discuss it with you. Your diagnosis, if any, will have no impact on the amount you are billed.
Estimated Duration of Recurring Services under this Estimate
This Good Faith Estimate of Client Costs is effective through the end of 2026.
Description of Services Provided
Counseling and/or psychotherapy as indicated on an approximately weekly basis.
Important Disclosures
Services are anticipated to be provided on a recurring basis until treatment is terminated. Additional services may be recommended. This estimate of your costs is only an estimate, and your actual charges may differ. You have the right to initiate the patient–provider dispute resolution process if the charges you are actually billed substantially exceed the expected charges in this estimate. You may contact us directly if the billed charges are higher than this Good Faith Estimate, or you can start a dispute resolution process with the U.S. Department of Health and Human Services (HHS) directly. If you choose to use the dispute resolution process, that will not adversely affect the quality of health care services we provide to you. This estimate of costs is not a contract and does not obligate you to obtain clinical services from us.