My name is Nicole Carissimi, and I grew up in a tiny town in Pennsylvania. It was so small that our one intersection had a blinking red light instead of a real stoplight. Like many kids, I went through phases about what I wanted to be: marine biologist, veterinarian, nurse anesthetist. Each option got crossed off the list after I shadowed someone in that role. Lesson learned: always shadow before you commit.
Drexel Graduation
Nursing stuck with me. I loved the many directions I could take it. I chose Drexel University partly for their co-op program, which provided real clinical experience during school. I also fell in love with Philadelphia. My final co-op landed me in the Neuro ICU at Jefferson University Hospital, and I genuinely loved it there. The brain fascinated me, but more than that, I adored the community. These jobs often become something bigger than work — they feel tight-knit and family-like. Some of my very favorite people in my life came from those units. After graduation, I stayed on in their step-down neuro unit, then moved to the Neuro ICU at Pennsylvania Hospital, where I continued to grow both clinically and personally.
"I loved how many directions you could take it."
A Shift in Perspective
During my time in the ICU, something started to shift within me. We were doing everything right — good intentions and excellent care — but I found myself increasingly affected by the suffering we sometimes prolonged. When you're in critical care long enough, you begin to grapple with the gap between what medicine can do and what patients and families actually want. This tension eventually led me to an assistant nurse manager position at Penn Medicine's inpatient hospice unit. It turned out to be one of the best decisions I ever made. The same family-like culture I had always gravitated toward was present, but the focus was different. It centered on comfort, dignity, and being truly present with people during the hardest moments of their lives.
My Pennsylvania Hospital Family
All while I was working through the PMHNP program at the University of Pennsylvania — full-time nurse, part-time student, and zero free time.
Then 2020 happened. COVID hit right as my supervisor went out on medical leave, leaving me suddenly running an inpatient unit during a pandemic. My clinical hours were canceled, and I scrambled to finish my degree. Ultimately, I graduated in May 2020 via PowerPoint presentation — on the same day my dog went into emergency surgery. It was a lot.
Starting Over (Sort Of)
I passed my boards and reached out to the small private practice where I was already a patient. Miraculously, they said yes. They welcomed me with open arms and provided all the support I needed to find my footing as a new provider. After paying off my student loans, my husband and I began thinking about starting a family. In the middle of fertility treatment, our practice got acquired by a large corporation. Staying zen while learning new systems, manually migrating patient data, and working until 9 PM every night was... a challenge. We welcomed our son in June 2022, and I returned from maternity leave straight into back-to-back appointments, pumping every two hours, and receiving daycare calls about sniffles. He even made a few cameo appearances in my telehealth sessions. No regrets.
After a few years in the corporate model, I started to notice a shift. There were more productivity metrics, more "clinical care guidelines," and less time to actually be with patients. It wasn't the kind of medicine I wanted to practice. Around this time, I discovered integrative psychiatry: the idea that herbs, supplements, and lifestyle changes can work alongside traditional psychiatric care, not against it. We're trained to be skeptical of these approaches, but the research supports them if you look closely — and interactions can be safely managed. This opened up a whole new way of thinking about patient care.
And Then We Moved Across the Country
My family had also started to outgrow Philadelphia after nearly 20 years. We moved across the country to Nevada, fell in love with the scenery and parks, and appreciated the distinct lack of snow. With 4,500 miles between me and my old office, it felt like the right time to do things differently. I opened my own practice so I could practice psychiatry on my own terms — integrative, unhurried, and genuinely centered on the person in front of me.
If you've read this far: Hi, I'm glad you're here.
The Stuff That Doesn't Fit Anywhere Else
A little more about me that doesn't fit neatly anywhere: I joke that I'm equal parts secret 13-year-old boy (video games, questionable eating habits) and 70-year-old woman (knitting, cross stitch, and yes, bingo). I have rampant ADHD, which means my hobby list is long and ever-expanding. I enjoy rock climbing, hiking, puzzles, and running when the mood strikes. I also bike with my son and color, albeit badly, because it relaxes me.
My goal is simple: I want to help you thrive, not just survive.
In this journey, I have learned that mental health care is not just about treating symptoms; it's about understanding the whole person. I believe in a holistic approach, one that considers all aspects of life. Whether you are struggling with anxiety, depression, or any other mental health challenge, I'm here to support you. Together, we can explore integrative options that may enhance your well-being.
If you're interested in learning more about how I can help you on your mental health journey, feel free to reach out. Let's embark on this path together, focusing on your unique needs and goals.
