Services

I believe healing rarely comes from one solution in a single bottle. My approach blends traditional psychiatry with integrative tools, honest conversation, and small, sustainable changes, because real progress usually takes more than one piece working together.

Diagnoses & Conditions I Treat

I work with adults, with particular depth in:

  • ADHD, especially if you were missed or diagnosed later in life

  • LGBTQ+ affirming care

  • Insomnia and sleep

  • Anxiety, including the kind that turns out to be ADHD in disguise

  • Bipolar disorder

I also work with people in the middle of big life changes, such as new parents, who may not be diagnosed with one particular thing, but know they need holistic medical support.

Person with colorful hair using a laptop in a cozy living room armchair
Book a Free Consultation

  • ADHD

    Diagnosed at 12, diagnosed at 42, or still wondering. I especially love working with people who were missed or diagnosed late, because I'm one of them. We'll build a plan around your actual brain, not someone else's productivity hack. That usually means medication, better sleep, and small habit changes that stick, not just a prescription and a follow-up in three months.

  • LGBTQ+ affirming care

    Good LGBTQ+ care shouldn't be a scavenger hunt. With me, you don't have to explain yourself before you get help, or brace for judgment that has no place in your care. I'm an ally who keeps learning, and I see LGBTQ+ adults for ADHD, depression, anxiety, insomnia, and more. ADHD and neurodivergence overlap a lot in the trans and nonbinary community, so I look at the whole picture, not one label at a time.

  • Insomnia

    I treat insomnia as part of the bigger picture, not a minor symptom, because a rested brain does better work on everything else. If you've tried a lot on your own, or been handed a sleeping pill and sent on your way, we'll look at what's actually keeping you up. Your plan might include CBT-I–based strategies, supplements, or medication when it's the right tool. The behavioral piece takes commitment, but plenty of people tell me it was worth it.

  • Anxiety & depression

    Not every case of anxiety or depression is just anxiety or depression. Sometimes there's ADHD underneath, and the anxiety is a workaround for a brain that can't keep track of its own life. Sometimes it's sleep, a thyroid issue, or years of white-knuckling it. And if a medication or two hasn't worked, that doesn't mean nothing will. It may mean the plan wasn't built around you yet.

  • Life transitions (including new parents)

    New baby, new city, new job, new everything. Everyone warned you about the sleepless nights, and nobody told you about the rest. I help adults find their footing during big changes, whether that's anxiety that shows up out of nowhere, sleep that won't cooperate, or the feeling that you're doing it wrong. (You're probably doing a great job.)

  • Bipolar disorder

    The right diagnosis and the right medication can make a huge difference, especially for people who've struggled with depression since their teens and found antidepressants don't work for them. I work with adults with bipolar disorder to build a stable, sustainable plan, and I'm glad to coordinate with your therapist and other providers.

You're not a diagnosis. You're not a checklist of symptoms. You're a person who's been doing all the work, just maybe not in the right direction, and you're ready for that to change.

That's why I don't believe in one-size-fits-all care. My approach rarely fits in one bottle.

I believe in slowing down, actually listening, and building a plan around you:
your habits, your sleep, your real life, not a textbook.

Medication can be a game changer, but it's rarely the whole game.

So here's what's in my toolkit, mixed and matched to fit your real life:

Treatment Modalities

  • Thoughtful, not cookie-cutter. Plenty of "failed" meds just never got the right dose or combination.

  • Many supplements and other evidence-informed options, can be layered in alongside your meds or used on their own when appropriate. I also add labs when helpful to make sure we understand the full picture.

  • Most of my patients struggle with sleep and it is a serious factor that I heavily focus on because I know the impact it can have.

  • We take an integrative approach looking at the whole person including lifestyle habits, environment, history and more. I focus on small realistic changes that fit you and will stick, rather than an idealistic checklist of habits or overhauling your life in one week.

  • I hated exercise for years, until I found rock climbing. Now I've run a 3K and a 5K, which past me would not believe. We'll find your version, because if it isn't fun, you won't do it.

  • I often start my appointments talking about video games, your latest knitting project or life updates. And while we always focus on the issues at hand, I’m someone who is authentic, honest, realistic, and often finds that a good laugh never hurts, even amidst the hard moments.

What It's Like Working with Me

The comment I hear most:

"You're the first provider I've actually liked and felt like a real human."

Here's what I think they mean.

  1. I'm direct, and kind about it.

    If something isn't going to help, I'll tell you why and we'll find something better. Forgot your meds again? I'm not mad. You're a grown-ass adult, and we'll figure out what got in the way.

  2. Not much rattles me.

    Say the awkward thing. Say the embarrassing thing. I promise I've heard weirder.

  3. We can talk about your world.

    Some sessions start with what you're playing or knitting. Comfortable people tell the truth.

  4. It's your plan.

    We build it together, using evidence-based care, with you in the driver's seat.

  5. Longer visits, quick replies.

    I answer portal messages within an hour or two on business days. Your next visit gets booked before you log off, and you can reschedule online.

Appointment Types & Fees

90-Minute Intake Appointment

This is where we start. We'll review your history, current symptoms, and any past treatment, talk through your goals, and begin building a plan together.

$325

50-Minute Follow-Up (Psychotherapy and/or Medication Management)

A longer follow-up appointment for reviewing progress, discussing medication changes, working through lifestyle adjustments, and providing supportive therapy as needed.

$250

Anthem Blue Cross and Blue Shield logo
Carelon Behavioral Health logo

25-Minute Follow-Up (Medication Management)

A focused check-in for medication management, reviewing how things are going and addressing any side effects or adjustments.

$200

Insurances Accepted:

Purple text that reads "aetna" with a heart symbol in place of the word "love".
Logo for Cianda featuring a stylized tree with green leaves, a blue trunk, and an orange circle representing a person, along with the text 'Cigna' below.

  • "Great, caring and very professional. Nicole has identified my problems and took a different approach to reach my goals of getting out of my episodes. Would highly recommend her to anyone."

    —Anonymized Client

  • "Nicole has been my favorite provider I've ever worked with. She has such a calm, down-to-earth presence that makes every appointment feel comfortable and stress-free. She listens, understands, and always makes you feel heard. You never feel rushed or judged, and it's clear that she genuinely cares about her patients. Simply put, she just gets it. I can't recommend her enough."

    —Anonymized Client

  • "Nicole Carissimi is great! Highly recommend her. She’s compassionate and easy to talk to!!"

    —Anonymized Client

  • "I always feel so much better after I speak with Nicole. She makes me confident in how I feel about what is happening in my world. I really appreciate her. Many Thanks"

    —Anonymized Client

Ready to Begin?


If you're ready to take the next step, I’m here to walk it with you.

Click below to schedule your free 15-minute consultation.

Schedule Free Consultation Here