Notice of Privacy Practices

Heavenly Counseling, PLLC
Alexandr Philip, MA, LPC-S
2201 Spinks Road, Suite 118, Flower Mound, TX 75022
(940) 240-2234 · info@heavenlycounseling.com

Effective date: November 12, 2026

THIS NOTICE DESCRIBES HOW MEDICAL AND MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

My commitment to your privacy

I am required by law to maintain the privacy of your protected health information (PHI), to give you this notice of my legal duties and privacy practices, to follow the terms of the notice currently in effect, and to notify you if a breach of your unsecured PHI occurs. PHI is information that identifies you and relates to your past, present or future physical or mental health, the care you receive, or payment for that care. Texas and Florida laws that protect mental health records are, in some cases, stricter than federal law. When they are, I follow the stricter rule.

How I may use and disclose your information without your written authorization

Treatment. I use your information to provide counseling. With your knowledge, I may consult with or coordinate care with other providers involved in your care, such as your physician or psychiatrist. When I consult with colleagues or a clinical supervisor, I do not share information that identifies you unless you agree.

Payment. I may use and disclose information to bill and collect for services, for example sending your insurance company or Medicare the dates of service, diagnosis and type of service so your claims can be paid, or confirming your eligibility and benefits.

Health care operations. I may use information to run the practice, for example quality review, record keeping, licensing, audits and legal or professional advice.

Business associates. Some services are provided by outside companies, such as my electronic health record and telehealth platform, scheduling, secure email and billing. These business associates must sign a written agreement to protect your information.

Appointment reminders and practice information. I may contact you to remind you of appointments or to share information about services I offer.

Other uses and disclosures permitted or required by law

I may use or disclose your information without your authorization in the following situations, and only to the extent the law allows or requires:

  • Serious threat to health or safety. If I believe there is a probability of imminent physical injury by you to yourself or others, or immediate mental or emotional injury to you, I may disclose information to medical or law enforcement personnel, or to others as permitted by Texas or Florida law.
  • Abuse or neglect. I am required to report suspected abuse or neglect of a child, an elderly person or a person with a disability to the appropriate state agency.
  • Judicial and administrative proceedings. I may disclose information in response to a court order or as otherwise permitted by law. I will not release your records in response to a subpoena alone without your authorization or a court order, unless the law requires it.
  • Health oversight. I may disclose information to licensing boards and other agencies authorized to oversee health care, such as the Texas Behavioral Health Executive Council or the Florida Department of Health, for audits, investigations or licensure.
  • Required by law. I will disclose information when federal, state or local law requires it, including to the U.S. Department of Health and Human Services to show compliance with HIPAA.
  • Law enforcement, public health, coroners, specialized government functions and workers’ compensation, only as specifically permitted or required by law.

Uses and disclosures that require your written authorization

  • Psychotherapy notes. If I keep separate psychotherapy notes, they are given extra protection and will not be used or disclosed without your written authorization, except in the limited situations the law allows.
  • Marketing. I will not use or disclose your information for marketing without your written authorization.
  • Sale of information. I will never sell your information.
  • Substance use treatment records. If I receive records protected under federal law (42 CFR Part 2), I will not use or disclose them in any civil, criminal, administrative or legislative proceeding against you without your written consent or a court order that meets the requirements of that law.
  • All other uses not described in this notice require your written authorization. You may revoke an authorization in writing at any time, except to the extent I have already acted on it.

Your rights

  • Right to see and get a copy of your records. You may ask to inspect or receive a copy of your health information, including an electronic copy if your records are kept electronically. Requests must be made in writing. I will respond within the time allowed by law (for electronic records under Texas law, within 15 business days). I may charge a reasonable, cost-based fee. In limited circumstances I may deny access if I believe disclosure would be harmful to you, and you may ask for that decision to be reviewed.
  • Right to request a correction. If you believe information in your record is incorrect or incomplete, you may ask in writing that I amend it. I may deny the request and will tell you why in writing.
  • Right to request restrictions. You may ask me to limit how I use or disclose your information. I am not required to agree, except that if you pay for a service in full out of pocket, you may ask that I not share information about that service with your health plan, and I will agree unless the law requires the disclosure.
  • Right to confidential communications. You may ask that I contact you in a particular way or at a particular place, such as only on your cell phone or at a specific email address. I will accommodate reasonable requests.
  • Right to an accounting of disclosures. You may ask for a list of certain disclosures I have made of your information in the past six years, other than those for treatment, payment, operations, or those you authorized.
  • Right to a paper copy of this notice, even if you agreed to receive it electronically.
  • Right to choose someone to act for you. If you have given someone medical power of attorney or have a legal guardian, that person may exercise your rights.
  • Right to be notified of a breach of your unsecured health information.

Electronic communication and telehealth

Telehealth sessions are conducted through a secure, HIPAA-compliant platform. Email and text messages can carry some risk of interception. I use them only for scheduling and administrative matters unless you request otherwise in writing. Please do not use email, text or the website contact form to share clinical details or for emergencies. If you are in crisis, call or text 988 or call 911.

Changes to this notice

I may change the terms of this notice, and the changes will apply to all information I have about you. The current notice will be posted on this website and available in the office, and you may request a copy at any time.

Questions and complaints

If you have questions about this notice or believe your privacy rights have been violated, please contact my Privacy Officer:

Alexandr Philip, MA, LPC-S, Privacy Officer
Heavenly Counseling, PLLC
2201 Spinks Road, Suite 118, Flower Mound, TX 75022
(940) 240-2234 · info@heavenlycounseling.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or online at www.hhs.gov/ocr/complaints. Texas clients may also contact the Texas Behavioral Health Executive Council, and Florida clients the Florida Department of Health. I will not retaliate against you in any way for filing a complaint.