Bespoke Counseling
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  • About Melissa
  • Locations
  • FAQs
  • Notice of Privacy Practices
  • No Surprises Act
  • Contact Us
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If you are in need of urgent or emergency services, please call 911 or proceed to the nearest emergency room to maintain your immediate safety. 
By completing the form below:
I understand that the use of email is inherently insecure and thus poses a risk to the security and confidentiality of my protected health information and consent to Bespoke Counseling Services LLC communicating to me by non-secure email at the address provided Protected Health Information (PHI) related to the scheduling of therapy sessions and/or other appointments.
    Please note that these services are unable to be provided by our clinicians; however, we have a network of professional connections who have specialization in these areas. We aim to provide referrals in hopes of reducing the time and effort it takes to align with a resource who can best provide the needed services.
    Check all that apply
    Please note that Bespoke Counseling Services is not contracted with any insurance providers; however, we can provide a receipt of payment which may be reimbursed by some insurance companies. Please review your specific plan to determine if it participates in "out-of-network billing".
    Although Bespoke Counseling Services does not accept insurance coverage, we do attempt to provide referrals to other professionals who may be able to help.
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Telephone                                 Fax           

317-604-9889                        (317) 300-0949     

Email

[email protected]