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Additional Information


Please read through the following FAQs and office policies for additional information. If you have further questions, please complete the contact form and we will get back to you as soon as possible. Scroll all the way to the bottom for emergency/crisis information.

Pura Vida Psychiatry accepts Cigna, Aetna and BCBS and is out-of-network for all other insurances including Medicare and Medicaid.

Many insurance plans have an out-of-network mental health component that will reimburse you directly after you submit a superbill, which can be provided to you upon your request.  Please call your insurance company to verify out-of-network coverage prior to scheduling your appointment. See bottom of page for more information about requesting out-of-network coverage.

Self-pay payments are made by credit card through the scheduling system and due in full at the time of appointment booking. This is considered necessary to hold your appointment.

All major credit cards are accepted.

We will obtain your insurance information prior to the first session as this information is necessary for ordering lab work and creating the superbill.

We accept Cigna, Aetna, BCBS of MA and Optum (United Healthcare, Oscar Health, and Oxford).

For all other insurance HMO plans will not reimburse any portion of the visit, in which case sessions would be out-of-pocket. 

The following types of insurances may reimburse you a portion of your session fees following an annual deductible.

Preferred Provider Organizations (P.P.O.)

Point of Service Plans (P.O.S.).  

 In order to maintain professional boundaries and the viability of the practice, we have a strict cancellation policy. 72 hours advanced notice is required to cancel or reschedule an appointment. Cancellations or appointments rescheduled within less than 72 hours in advance will incur a $50 fee, those canceled or rescheduled within less than 48 hours in advance will incur a $75 fee, and those cancelled or rescheduled within less than 24 hours in advance will be required to pay the full session cost. No shows will also be required to pay the full session cost and will not be refunded.

If a client cancels or no shows and does not respond after 2 attempts of contact within two weeks, client will automatically be discharged from services. 

If maintaining a scheduled in-person appointment is ever a concern due to inclement weather, the option for a telehealth session is available. 

Maryam is a doctoral-prepared, board certified psychiatric nurse practitioner with the following degrees:

  • Doctorate of Nursing (University of Massachusetts, Amherst)

  • Masters of Nursing (University of Massachusetts, Amherst) 

  • Post-Master's Certificate -PMHNP (University of Massachusetts, Amherst)

  • Bachelors of Art, English (Worcester State University)

  • Associate of Science, Massage Therapy (Springfield Technical Community College)

Maryam has additional training in the following:


Integrative and Nutritional Psychiatry (Leslie Korn)

Training in Integrative/Functional Psychiatry (Dr. James Greenblatt, ongoing)

Maternal Mental Health (Postpartum Support International)

Integrative Environmental Health (Arizona State University)

The Role of Spirituality in Mental Health (NetCEs)

Embodied Processing (The Centre for Healing)

The Art and Science of Herbalism (Rosemary Gladstar, in progress)

Perinatal, oncology, and deep tissue massage

PMHNP-BC #2020015751

Massachusetts CNP #RN2272979

We practice from a root-cause perspective. Because the monoamine theory of depression (and other mental health conditions) has not been proven, psychopharmacology cannot be considered a means of treating the cause of an illness. Often, medications mask symptoms, and while they can help a patient to feel better for a time, they do not treat the root cause of symptoms. They can lead to medication dependence, cause withdrawal symptoms, and in the long-term can do more harm than good. When a client is in acute distress and unable to take the steps toward change and wellness due to their current mental state, conservative psychopharmacology may be considered as a supportive, albeit temporary treatment measure. We do however, have a policy to not prescribe controlled substances such as stimulants (i.e., Adderall) or benzodiazepines (i.e., Ativan, Klonopin).

Typical psychiatry follows the DSM-V method of diagnosing mental health conditions. These diagnoses are based upon empirical data, as there are no objective diagnostic tests that can definitively point to a mental health diagnosis as outlined by the DSM. At Pura Vida Psychiatry, we are not a fan of labels, as once a label/diagnosis is placed, it generally stays with you for the long-term. We know that we are more than our symptoms, and that they do not define us. When symptoms present, there is generally an underlying (root) reason or cause, which may have origin in mind, body, or spirit, or have a combination of contributing factors from each of these. Oftentimes, symptoms are caused due to neurotoxic stress and malnutrition. These are areas that should be carefully examined, and strides can be made in counteracting the adverse effects they may have caused. Past trauma, and faulty thought patterns that may arise are also often culprits. This being said, there are a number of psychiatric symptoms and issues that we treat. These include:

  • Stress (the number one cause of illness)

  • Fatigue

  • Emotional distress

  • Anxiety

  • Depression

  • Obsessions and compulsions

  • Irritability

  • Anger

  • Low self esteem

  • Worthlessness

  • Guilt

  • Shame

  • Lack of motivation

  • Trauma/PTSD

  • Sleep issues

  • Perinatal mental health

  • Grief

If there is a symptom you are experiencing that is not listed here, please ask.

What we do not treat: severe psychiatric illnesses such as schizophrenia or symptoms such as self-harm, homicidality, or suicidality. In these cases, we would refer out to an acute care provider or facility.

We practice holistically (incorporating mind-body-spirit) with a root-cause perspective. Treatment plans are entirely individualized as we do not believe in a one size fits all, cookie cutter approach to wellness (or anything for that matter). Diagnostics include a thorough biopsychosocial-spiritual assessment. Other assessments are also used depending upon your background and presenting symptoms. Laboratory data is also often used to determine any contributing biological factors such as micronutrient deficiencies, or hormonal imbalances. We may use a variety of treatment approaches based on your individual preferences and needs which may include:

  • Supplementation/Nutrient Therapy

  • Dietary changes

  • Lifestyle medicine

  • Somatic Psychotherapy 

  • Mind-body therapies (massage, yoga, meditation, prayer)

  • Energy psychology (EFT, CCT)

  • Aromatherapy

  • Psychopharmacology

  • Supportive psychotherapy

  • Wellness coaching

  • Narrative therapy

  • Parenting support

  • Christian counseling

Please make sure you have read through this page on FAQs and office policies. Once you have scheduled your appointment, you will be sent links to complete a client information sheet and a virtual intake form. These must be completed within 72 hours (3 days) of your scheduled appointment and if it has not been completed, the appointment will need to be rescheduled to a future date. You will also be required to sign a form acknowledging that you have read our policies and that you agree to them and understand how our practice operates. 


It is your responsibility to obtain previous medical records from other physicians, or health care providers that you feel would be pertinent to your care and would like us to review. These records can only be released with your authorization. Please contact your other providers to obtain these records and fax or email them to us or bring them to your initial appointment. For uninterrupted care, please make sure they have been delivered to us no later than your second intake appointment. 

In addition, we request that you gather as much collateral information as possible to bring to your first session. This could include previous allergy testing, blood work, lab work, nutritional evaluations and psychological testing. Also be sure to accurately provide information on any current medications including over-the counter, supplements, and herbal preparations.

You will complete additional forms such as a release that allows us to speak with your other provider(s), a HIPAA form, our lab work policy, other consent forms, etc.

You may be asked to complete specific health assessment questionnaires, prior to your first visit, during your first visit, or during subsequent visits. 

Although there are a number of treatment approaches that are better offered face-to-face, we do offer both in-person and telehealth appointments based on the client's preference. 

Appointments can be scheduled through our Client Portal by accessing the link on the "scheduling" page. Appointments must be paid in full via credit card at the time of booking. 

We do our best to respond to emails and voicemails within two business days. If you have a medical emergency, call 911 or go directly to the nearest ER. Pura Vida Psychiatry is not able to provide emergency services. See bottom of page for additional crisis information.

For prescription refills please contact your pharmacy and have them fax over the medication refill request. Our fax number is (915) 221-6127. It may take up to 72 business hours to process a prescription refill. Please plan ahead to avoid any interruptions in your medications. There is a $35 charge to process medication refills in-between appointments, which must be paid at your subsequent session. Pura Vida Psychiatry may refuse to refill medication if it is deemed clinically necessary to evaluate patients before prescribing a medication.







Out-of-Network (OON) coverage

Prior to scheduling your appointment, contact your insurance company (member service number can be found on your insurance card) and inquire as to whether your plan reimburses for out-of-network behavioral health services.

If you are informed that your plan does in fact cover out-of-network behavioral health services, you may ask additional questions regarding this coverage, including:

  • Are the following CPT codes covered?

    1. Intakes: CPT code 90792, 99204, 99205

    2. Follow-up visits: CPT code 99214, 99215, 90833, 90836, 90838

  • Are any diagnoses excluded from reimbursement?

  • How much is my deductible?

  • After meeting my deductible, how much will the plan reimburse for each visit?

  • Do out-of-network services count toward the deductible?

  • What is the percentage of reimbursement?

  • Is the number of visits limited?

  • Is there specific information I need from my OON provider?

  • How can I submit a claim?

If your insurance plan provides reimbursement for OON behavioral health services, please notify the office and you will be provided with an invoice known as a superbill which can be submitted to your insurance company. Pura Vida Psychiatry will not submit the claim directly to your insurance company as an OON provider.

Please note that your insurance company may only reimburse you for a portion of the session fee. Reimbursement rates vary by insurance provider and plan (usually between 20-80%).

Emergency/Crisis Services

  • If you are experiencing a psychiatric emergency, call 911 or go to your nearest emergency department.

  • If you or someone you know in Massachusetts are experiencing a mental health crisis, the Emergency Service Program/Mobile Crisis Intervention is available 24/7, 365 days a year.

Additional Assistance​​

  • National Suicide Prevention Hotline: 800-273-8255

  • National Domestic Violence Hotline: 800.799.SAFE (7233)

  • National Alliance on Mental Illness (NAMI):

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