Margaret Cook, NP
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 provide psychiatric care in Richmond, VA to children through young adults, with a focus the mental health needs of the neurodivergent and queer community.
About:
I am a solo-practitioner, one-person operation. I began this practice to offer an alternative to corporate, generic, assembly-line mental health care. My approach is collaborative and individualized. Your lived experience is centered and valued in our work together. My goal is to create a space where individuals whose identities have historically been marginalized and harmed by psychiatry - namely people of color, queer and gender non-conforming people, and women - can develop a sense of safety and trust knowing that mental health treatment does not require submission to the mental health system. My practice is explicitly social justice oriented with a focus on not just acceptance, but rather affirmation of neurodivergence, gender-nonconformity/transgender rights, bodily autonomy and reproductive rights, and anti-racism. Individuals who do not affirm these values are not a good fit for my practice.
Practice overview:
My initial evaluations are 90 minutes long. My goal is to be as thorough as possible so I can fully understand your history, experience, and goals. Subsequently, we'll make a plan about medication changes and adjustments. I practice with a focus on de-prescribing, meaning cleaning up unnecessary and excessive medication regimens and working with individuals to achieve their goals on as few medications as possible. I am conservative with controlled substances and place a heavy emphasis on safety. Follow up appointments are typically 30 minutes. The frequency of appointments varies based on individual needs - we may meet every 2 weeks if we're making significant changes, and we can push out sessions farther apart once we feel like you're closer to your goals and no longer require such close monitoring. The maximum time that can go between appointments is 3 months. There is no requirement to take medications to work with me; however, it is important to make the distinction that as psychiatric NP, my role is different than that of a psychotherapist; therapy is certainly a component of our work, as I reject the reductionist concept of "medication management" and value our relationship beyond the prescription of medications. However, most patients also work with a psychotherapist in addition to myself for a more comprehensive, collaborative team approach. There is much overlap in the roles, but it is an important distinction to clarify the different scopes of practice, education, and services provided.
About me:
I have been a PMHNP since 2017, and before that a psychiatric nurse since 2013. I received both my BSN and MSN at Virginia Commonwealth University, where I have also served as adjunct faculty. I've worked in many different settings, including acute inpatient, eating disorders, child and adolescent, PHP and IOP, consult liaison, and corrections. I was born and raised in Cambridge, MA. I made my way to Virginia to live in an egalitarian intentional community of about 100 where income and resources where shared. After two years there, I moved to Oakland, CA to earn 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. It was there that. I learned what a nurse practitioner was and immediately felt called to the role. 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.
Please note:
As a solo practitioner without support staff, I have limitations on what I can provide. Please carefully review the following when determining if I'll be a good fit for you: I cannot provide crisis management, and do not provide any type of after hours call. I am not able to support individuals who need significant care outside of scheduled sessions. A larger practice with 24/7 call would be a more appropriate fit. My schedule is limited, and I can only rarely accommodate late afternoon appointments. If you are not able to meet before 3pm, I will not be a good fit for you. If you have medical conditions that impact your psychiatric care and require extensive monitoring and medical oversight, you would be better served by an integrated medical/psychiatric practice, as I do not have the bandwidth to cross manage medical and psychiatric care. I do not provide detox or MAT - again, this requires a higher level of monitoring than I am capable of managing in a solo practice. I am conservative with controlled substances (stimulants, benzodiazepines) and have a strict controlled substance policy that must be signed. If you are currently on a controlled substance, I cannot guarantee I will continue that medication depending on clinical evaluation and judgment. I am not able to take individuals on high daily doses of benzodiazepines (Xanax, Ativan, Klonopin, etc) as such regimens are often dangerous and can present a medical risk and may require detox.
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.