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Notice of Privacy Practices – Mapping Resilience Therapy Center Notice of Privacy Practices – Mapping Resilience Therapy Center
Chart the Path
Chart the Path

Notice of Privacy Practices

Protecting Your Information Along the Journey

Effective Date: 10.21.2025

Mapping Resilience Therapy Center LLC is committed to protecting your privacy and maintaining the confidentiality of your protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable state laws while supporting your path toward healing.

This Notice of Privacy Practices describes how medical and mental health information about you may be used and disclosed and how you can get access to this information.

Review carefully as this notice applies to all records of your care generated by this practice.

What Information May Be Collected

We may collect the following Protected Health Information (PHI) through the course of providing psychotherapy services:

  • Demographic Information
  • Name, address, phone number, email
  • Date of birth
  • Emergency contact information
  • Insurance information (if applicable)
  • Clinical Information
  • Reason for seeking treatment
  • Mental health history and diagnoses
  • Treatment plans and progress notes
  • Psychological assessments
  • Medication information
  • Session Information
  • Dates and times of appointments
  • Session notes and observations
  • Treatment outcomes
  • Referrals to other providers
  • Billing Information
  • Payment history
  • Insurance claims information
  • Superbills and receipts

How Your Information Is Used

We may use and share your Protected Health Information (PHI) to:

  • Provide therapy, coordinate care, or manage your mental health care. This may include consultation with other healthcare providers involved in your care, with your knowledge.
  • Process billing and insurance claims, This may include submitting claims to your insurance company, providing superbills for out-of-network reimbursement, or discussing payment arrangements.
  • Support internal administrative operations such as training, supervision and quality improvement.

When Information May Be Shared

Your care through Mapping Resilience Therapy Center is protected under the law that protects all relationships between clients and a psychotherapist. Information cannot be disclosed or shared without your written permission.

We may disclose your information without your written permission due to legal requirements under the following circumstances:

  • Safety
  • Suspected Abuse or Neglect
  • If I have reason to suspect child abuse, dependent adult abuse, or elder abuse, I am required by law to report this to the appropriate authorities immediately.
  • Threat of Harm to Others
  • If you communicate a serious threat of physical violence against an identifiable potential victim, I must take protective actions including notifying the potential victim, contacting the police, or seeking hospitalization.
  • Risk of Self-Harm
  • If you present an imminent risk of harm to yourself and we are unable to come to an agreement to maintain your safety. I may take further measures provided by law to protect your safety.
  • Legal proceedings
  • Court Orders
  • A court of law issues a legitimate court order requiring disclosure of your records.
  • Please review complete court involvement and fee schedule policy for specifics practice policies.
  • Government Oversight
  • Disclosures may be required to health oversight agencies for activities authorized by law, such as audits and investigations.

Additional Protected Disclosures

Psychotherapy Notes

These are process notes kept separate from your medical record and receive special protection under HIPAA. These notes are not disclosed without your explicit written authorization, except in very limited circumstances as required by law.

Substance Use Disorder Records

If you receive treatment for substance use disorders, your records related to that treatment receive additional protections under federal law (42 CFR Part 2).

  • Written consent or a court order is required to use such records in civil, criminal, administrative, or legislative proceedings against you.
  • Stricter limitations on disclosure apply compared to other medical information.
  • You have the right to revoke consent for disclosure at any time

Your Rights

You have the right to:

  • Access and request copies of your records
  • You have the right to inspect and obtain a copy of your health records. These requests must be made in writing. I charge a reasonable fee for copying.
  • Request corrections/amendments
  • You may request amendments to your health information if you believe it is incorrect or incomplete. I may deny the request under certain circumstances but will provide a written explanation.
  • Limit and restriction of certain disclosures
  • You may request restrictions on how your PHI is used or disclosed for treatment, payment, or healthcare operations. I may not agree to all restrictions, but will comply with requests to restrict disclosure to health plans for services you pay for in full out-of-pocket.
  • Receive an accounting of disclosures
  • You may request a list of disclosures that I have made of your PHI, except for disclosures for treatment, payment, healthcare operations, and certain other exceptions.
  • File a complaint without retaliation
  • If you believe your privacy rights have been violated, you may file a complaint without fear of retaliation through this practice or U.S. Department of Health & Human Services 1-877-696-6775
  • Confidential and preferred communication
  • You may request that I communicate with you in a specific way or at a specific location. I will accommodate reasonable requests.
  • Revocation of Authorization
  • You may revoke any previously provided written authorization for disclosure of your PHI authorization at any time in writing, except to the extent action has already been taken based on your authorization.
  • Physical copy
  • You have the right to obtain a paper copy of this Notice of Privacy Practices at any time.

To exercise any of these rights, please submit a written request to our office at: Mapping Resilience Therapy Center Attn: Privacy Policy Notice 5747 Nanjack Cir PMB 128 Memphis TN 38115

Technology & Secure Platforms

To support your care, we use HIPAA-compliant systems, including:

  • SimplePractice
  • Grow Therapy
  • SonderMind

These platforms operate as secure partners in your care.

Website Data and Cookies

In addition to health information collected in the course of treatment, this website may collect certain information automatically:

  • Browser type and version.
  • Operating system.
  • Pages visited and time spent.
  • Referring website.
  • IP address. (anonymized where possible)

This website uses essential cookies necessary for site functionality. We do not use advertising cookies or sell your data to third parties. Any analytics tools used are configured to respect user privacy and do not track individual users. Information collected through the website is kept separate from your protected health information and is used solely to improve website functionality and user experience.

Electronic Communications and Contact forms

When you submit information through this website contact form or communicate with us electronically, we take the following steps to protect your privacy.

How We Protect Your Form Submissions

  • Your information is transmitted using industry-standard encryption (TLS/HTTPS)
  • We use HIPAA-compliant cloud services to process and handle your submission
  • You may receive an automated confirmation email acknowledging your inquiry
  • Automated confirmations do not include details of your message to protect your privacy

While we use encryption for email transmission, standard email cannot guarantee end-to-end encryption. By providing your email address through our contact form, you consent to receive electronic communications from us, including automated confirmation emails. You may request alternative communication methods at any time.

Multi-State Telehealth Care

Services are provided based on the laws of the state where you are physically located during each session. Depending on your state of residence, you may have additional privacy rights. Below are state specific summaries for licensed service states:

  • California
  • Mental health records receive additional protections under California's Confidentiality of Medical Information Act (CMIA)
  • HIV related disclosures during therapy require specific patient authorization for
  • Providers must notify patients and the California Department of Public Health of any unlawful or unauthorized access or disclosure of medical info without unreasonable delay and within 15 days.
  • Florida
  • Records may not be furnished to any person without written consent except as provided by law
  • Specific protections for clinical records and communications with mental health providers
  • Right to confidentiality extends to licensed clinical social workers
  • New York
  • Mental health records receive additional protections under NY Mental Hygiene Law
  • HIV-related information requires specific written consent for disclosure
  • Patients may designate a personal representative for healthcare decisions
  • Pennsylvania
  • HIV-related information requires specific written consent for disclosure
  • Substance abuse disorder related records require specific written consent for disclosures
  • Mental health records require specific patient consent or a court order for disclosures
  • Breach of confidentiality and PHI require timely notifications of all agencies operating within the state
  • Washington
  • Clients may sue for breaches of confidentiality with limits on damages
  • HIV-related information requires specific written consent for disclosure
  • Mental health records require specific consent to share beyond treatment team

Data Breaches

In the unlikely event of a breach of your unsecured protected health information (PHI), we will notify you as required by law. Notification will include:

  • A description of what happened and the date of the breach
  • The types of information involved
  • Steps you should take to protect yourself
  • What we are doing to investigate and mitigate the breach
  • Contact information for questions

Changes to Privacy Notice

We reserve the right to change this Notice of Privacy Practices at any time. Any changes will apply to information we already have about you as well as any information we receive in the future. The current notice will always be posted on our website. The effective date of the current notice is listed at the top of this page.

Complaint Procedure

You may contact us or file a complaint with the U.S. Department of Health & Human Services.

Mapping Resilience Therapy Center
Attn:Complaints and Grievances
5747 Nanjack Cir
PMB 128
Memphis, TN 38115
Email: admin@mappingrt.com

U.S. Department of Health & Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Website: www.hhs.gov/ocr
Phone: 1-877-696-6775

Safe Exit

If you think someone is monitoring your devices, visit this website from a computer, tablet, or smartphone that isn’t being monitored.

Exit this website quickly with the ‘Safe Exit’ button in the upper right corner, and then delete it from your browser history.