Firefly Collaborative Mental Health
Inclusive psychiatric care for children, adolescents, and adults in Richmond and greater Virginia.
Welcome!
Thank you for visiting! My name is Margaret (she/her), and I’m a Psychiatric-Mental Health Nurse Practitioner (PMHNP). I focus on treating the mental health needs of the neurodivergent and queer community. I treat children through young adults and provide in-person care at my Richmond office as well as telehealth care throughout Virginia. I opened this practice to provide the kind of psychiatric care I believe in—an alternative to the check-the-box, generic, corporate “care” increasingly shaped by venture capital and market forces, one in which people of all backgrounds and identities can feel safe, affirmed, and centered.
Services:
Trauma-informed psychiatric care for children, adolescents, and young adults for conditions such as depression and other mood disorders, anxiety disorders, obsessive compulsive disorder, trauma related disorders, including complex and chronic PTSD. Prescribing, monitoring, and managing psychiatric medications in conjunction with therapy with a DBT (dialectical behavioral therapy) and CBT (cognitive behavioral therapy) influence. I recognize that many individuals are seeking support for attention and focus concerns, and I value the importance of providing thorough, thoughtful care in this area. At Firefly Collaborative Mental Health, ADHD evaluations are conducted with the same care and depth as all other diagnostic assessments. A note on ADHD treatment: because stimulant medications require careful monitoring and compliance with medical and regulatory standards, I approach prescribing them conservatively and only when clinically indicated. A prescription for stimulant medication is never guaranteed. If your primary goal is to obtain stimulant medication without a prior, formal ADHD diagnosis from comprehensive psychological testing, you may find another practice better suited to your needs. My approach emphasizes accurate diagnosis, collaborative treatment planning, and a range of evidence-based options tailored to each individual. 90 minute initial evaluations and 30-60 minute follow-ups tailored to the needs of each individual. Appointment frequency ranges from biweekly to quarterly, depending on the medication regimen and individual's needs and preferences.
Reclaiming Mental Health:
In order to create a space where all people can feel safe seeking mental health care, I believe it's crucial to first acknowledge the harms psychiatry has inflicted on entire groups of people over the years. Since the field's inception, those with mental illness have faced stark abuse and criminalization. People of color have been disproportionately institutionalized, women were subjected to lobotomies and hysterectomies, and homosexuality was listed as a sociopathic disorder in the DSM until the 1970s. Involuntary treatment has long been weaponized as a tool of control and domination, leading many to fear and mistrust psychiatry.
While there is still rampant bias against people of color, the queer community, neurodivergent and disabled people, and anyone who chooses to live a non-mainstream lifestyle, my hope in starting this practice is to provide a space where everyone can feel safe knowing their identity, lived experiences, and values will be respected and centered in their care. Fostering such a space is more important than ever with the ongoing societal changes leading so many to live in fear, not knowing who or where they are safe. To all who feel scared, marginalized, and oppressed in today's political climate, my promise to you is that you are safe under my care.
About me:
I have been a PMHNP since 2017, and before that a psychiatric nurse since 2012. I received both my BSN and MSN at Virginia Commonwealth University, where I'm currently adjunct faculty for the PMHNP program. I've worked in many different settings, including acute inpatient, eating disorders, child and adolescent, PHP and IOP, consult liaison, corrections and substance abuse. I was born and raised in Cambridge, Massachusetts, a city I am proud to call home. I originally made my way to Virginia to live in an intentional community in VA, where 100 people lived and worked together on an income-sharing farm. I went on to move to Oakland, CA, where I earned my BA at Mills College with a major in French and Francophone Studies and a minor in psychology. At Mills, I was inducted into the Phi Beta Kappa honor society and won the French Prize. I have three daughters, each born at home with under the care of an incredible midwife (IFKYK). I'm married to a Richmond City firefighter. I am a musical theater fanatic with a particular passion for Les Mis. While I'm a cat person at heart, I currently have one Quaker parrot and three parakeets.
Important Points about being a Solo Practitioner
Please note the following important limitations of my practice: As a solo practitioner without administrative or support staff, I have certain limitations in what I can offer. Individuals with the following needs may be better served in a larger practice with multiple providers, 24/7 on-call coverage, or integrated care settings that offer in-house labs, EKGs, and medical providers for seamless collaboration. 24/7 crisis management or after-hours support – I do not provide on-call coverage outside of scheduled visits. Detox, MAT, or acute substance use disorder management – These are best managed in specialized or higher-acuity settings. Extensive communication outside appointments – I cannot offer ongoing support beyond scheduled sessions. Standing weekly therapy-only sessions – I can accommodate a limited number of therapy-only clients for 60-minute visits, but I do not offer weekly hour-long sessions. Late afternoon availability – My practice generally ends by 3pm due to family responsibilities. While occasional later slots may be available, they are limited. If you or your child require regular care after 3pm, my practice may not be the best fit. Care for medically complex individuals – Those requiring frequent coordination with medical teams are best served in settings with closer integration of medical and psychiatric care.
Insurance Accepted:
Cigna Anthem BCBS Aetna United Optum Oscar Oxford Sentara I utilize Headway for insurance verification and billing; before starting services together, you will need to make a Headway account so we can make sure I'm in your network. Please click below to verify insurance coverage before we start together. Any questions about insurance coverage, benefits, or billing should be directed to Headway, as I outsource the financial management of my practice to them.
Frequently asked questions:
Am I a good fit for your practice?
While I am comfortable treating a wide variety of mental health conditions, as a solo-practitioner without clinical or admin staff, I am unable to meet the needs of individuals with more acute mental health needs. This includes individuals who are frequently in crisis who require extensive support and communication outside of scheduled visits. I am not able to provide crisis support nor be on-call; individuals requiring more intensive care are better served by a larger group practice that has multiple providers who can offer 24/7 call and may be able to facilitate inpatient admission when needed.
Do you provide 24/7 crisis support?
No. As a solo-practitioner, I am limited in my ability to provide care outside of scheduled appointments. I am generally very responsive to messages (I use a HIPAA compliant messaging platform called Spruce for communication), but it may take me up to a day or two to respond. If you are in crisis, you will need to call 911 or go to your closest ED rather than wait for me to responde. For this reason, if your mental health needs are more acute, you will be better served by a larger practice with more support infrastructure in place and 24/7 call.
What medications do you prescribe?
With a focus on safety, efficacy, and tolerability, I can prescribe antidepressants, anxiolytics, mood stabilizers, antipsychotics, ADHD medications, and sedative-hypnotics. I abide by all FDA and DEA regulations in prescribing. If controlled substances are indicated, we have a Controlled Substance Agreement that outlines our precautions and requirements for the safe and appropriate use of these medications.
Will you continue my current medications?
It depends. It is important to let me know in advance what you are currently taking if you wish to continue. I prescribe controlled substances very conservatiely and do not prescribe benzodiazepines and stimulants at the same time. Safety is my top priority and I practice fully in line with DEA guidelines and regulations. Individuals must sign a controlled substance agreement prior to starting care with me.
What ages do you treat?
I treat children with no minimum age through young adults. I do not treat older adults as this population is better served by a practice more specialized in treating the conditions and concerns common in this demographic.
Do you take insurance?
Absolutely. Mental health care must be accesible to all. I am currently in-network with Aetna, Cigna, Anthem BCBS, United, Oxford, Optum, Oscar, Setara (in process) and others down the road.
Do you do telehealth or in-person care?
Both! I feel strongly about the value of in-person care to foster a more authentic connection and rapport, especially when working with children and adolescents. My office is located in Richmond's West End in the Balance RVA Wellness-Based Coworking Space. I do provide telehealth as well, which plays an important role of making mental healthcare more accessible for individuals who cannot access in-person care.
What can I expect from a visit?
Initial visits are 90 minutes long. Follow ups are generally 30-45 minutes. Frequency is tailored to the individual needs and preferences. We talk about overall mental health progress, goals, life events, anything on your mind. We discuss medications of course too - but in my practice, I do not do exclusive "med management" and while discussing and evaluating medications is a big part of what I do, I do not put prescribing and managing medications ahead of the larger clinical picture and human sitting in front of me.
What is a nurse practitioner?
Nurse practitioners (NPs) are advanced-practice nurses who begin as registered nurses and pursue education at the Master's or Doctoral level. After passing board exams, NPs are trained to evaluate, diagnose, prescribe medications, perform procedures, and interpret bloodwork, among other tasks. While some NPs require physician supervision, I practice autonomously but deeply value the expertise of psychiatrists and other physicians, seeking consultation when needed.
One advantage of NP care is that, as nurses first, we often spend up to 12 hours caring for patients, developing rapport, and managing acute situations. As a nurse, my priority was always to advocate for patients, since oftentimes, we are the only ones doing so. My years as an RN have been invaluable to my work as an NP. This experience has helped me build empathy and develop skills to de-escalate patients with acute psychosis, mania, and aggression, deeply shaping my approach to patient care.
Do you have a supervising physician?
I have autonomous practice, meaning I have practiced long enough to no longer require physician supervision. However, that does not mean I have ceased seeking supervision and collaboration from physicians. The best patient care results from collaboration among healthcare providers of every stripe (and abbreviation) - NP, MD, DO, PA, RN, RD, OT, PT. We all bring something unique to the table, and collaboration is at the heart of caring for patients.
Why the name Firefly Collaborative Mental Health?
Fireflies represent a light in the darkness and a sense of wonder and joy even in the darkest of times. Collaborative because collaboration with each patient is the heart of our approach. We develop treatment plans collaboratively and center your voice and your personal goals and priorities during our work together. Treatments are made collaboratively after carefully reviewing the risks and benefits of different treatment options. Questions and curiosity are encouraged, and decisions are never made unilaterally.
