Brave Bloom Counseling is the clinical practice of Brave Bloom LCSW PLLC. At Brave Bloom LCSW PLLC, your privacy and transparency around care are foundational. The information below explains how personal information collected through this website and health information collected during clinical services are protected, and outlines your rights as a self-pay client.

Notice of Privacy Practices

Effective Date: February 16, 2026

My Commitment to Your Privacy

Brave Bloom LCSW PLLC is committed to protecting the confidentiality of your Protected Health Information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable New York State law.

How Your Information May Be Used and Disclosed

For Treatment: Your PHI may be used to provide, coordinate, or manage your mental health care. This includes documentation of sessions and consultation with other providers at your request.

For Payment: As a private pay practice, PHI may be used to provide receipts, invoices, or superbills upon request.

For Health Care Operations: Your PHI may be used for practice management, compliance, quality assurance, and administrative purposes.

As Required by Law: PHI may be disclosed when required by law, including court orders, mandatory reporting laws, or situations involving serious and imminent threats to safety.

With Your Written Authorization: Uses or disclosures not described in this Notice will be made only with your written authorization. You may revoke your authorization in writing at any time, except to the extent that action has already been taken in reliance on it.

Special Protections for Psychotherapy Notes

Psychotherapy notes maintained separately from your clinical record receive additional protection under HIPAA and will not be disclosed without your specific authorization except as permitted by law.

Your Rights

You have the following rights regarding your PHI:

• The right to inspect and obtain a copy of your clinical record (with limited exceptions permitted by law)

• The right to request an amendment

• The right to request an accounting of certain disclosures

• The right to request restrictions on certain uses or disclosures

• The right to request confidential communications

• The right to receive a paper copy of this Notice

Timeframe for Requests: Requests to exercise the above rights must be submitted in writing. Brave Bloom LCSW PLLC will respond within thirty (30) days of receipt. If additional time is needed, the practice may extend the response period by up to thirty (30) additional days and will provide written notice of the reason for the delay.

Electronic Communication & Telehealth

Brave Bloom LCSW PLLC is a telehealth practice. Encrypted platforms are utilized; however, electronic communication carries inherent risks, which are discussed in your informed consent documentation.

Business Associates

Third-party vendors who perform services involving PHI on behalf of the practice are required to enter into Business Associate Agreements (BAAs) and are contractually obligated to safeguard your information.

Data Retention

Clinical records are retained for a minimum of six (6) years from the date of last service, in accordance with New York law.

Legal Duties

Brave Bloom LCSW PLLC is required by law to:

• Maintain the privacy of your PHI

• Provide you with this Notice

• Abide by the terms of this Notice

• Notify you in the event of a breach of unsecured PHI

Changes to This Policy

This Notice may be revised at any time. The current version will be posted on the practice website and will be available upon request. Revisions apply to all PHI maintained by the practice.

Questions or Complaints

If you have questions or believe your privacy rights have been violated, you may contact:

Brave Bloom LCSW PLLC
Kristen Valletta, LCSW, ACSW, CASAC-Master, Q-SAP
Email: kristen@bravebloomcounseling.com

You may also file a complaint with the U.S. Department of Health & Human Services, Office for Civil Rights. Information about filing a complaint is available at www.hhs.gov/ocr. You will not be retaliated against for filing a complaint.

Good Faith Estimate (No Surprises Act)

Under the No Surprises Act, you have the right to receive a Good Faith Estimate explaining how much your medical and mental health care will cost.

Because Brave Bloom LCSW PLLC is a private-pay practice, you are entitled to receive a written Good Faith Estimate of the expected charges for services before scheduling services or upon request.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.

You may request a Good Faith Estimate at any time by contacting the practice at kristen@bravebloomcounseling.com.

For more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.