Ingredients Therapy Services LLC
Notice of Privacy Practices
Effective date: June 9, 2026
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
1. About This Notice
Ingredients Therapy Services LLC provides outpatient mental health services exclusively through telehealth to clients in Pennsylvania, New Jersey, Delaware, and Michigan, consistent with applicable professional licensing and state requirements.
This Notice explains how protected health information (PHI) may be used and disclosed, your rights regarding that information, and our legal responsibilities. It applies to PHI associated with services provided through telehealth.
The practice currently uses Headway for clinical intake, electronic health records, clinical documentation, telehealth services, insurance verification, and billing. Headway and its affiliated clinical entities maintain their own applicable privacy practices and notices.
2. How We Use and Disclose Your Health Information
Treatment: Providing psychotherapy, coordinating care, making referrals, and communicating with other healthcare professionals involved in treatment.
Payment: Verifying insurance eligibility, submitting claims, processing payments, and resolving billing matters through Headway and applicable payers.
Healthcare operations: Maintaining records, supporting quality improvement and administration, and meeting professional and legal obligations.
We may also disclose information when legally permitted or required, including for public health activities, suspected abuse or neglect, serious threats to health or safety, healthcare oversight, certain legal proceedings, and other legally authorized purposes. Additional federal and state confidentiality laws may apply.
3. Uses and Disclosures Requiring Authorization
We generally require written authorization for uses or disclosures not otherwise permitted or required by law. Authorization is generally required for most uses or disclosures of separately maintained psychotherapy notes, certain marketing activities, and the sale of PHI.
You may revoke an authorization in writing, except to the extent action has already been taken in reliance on it.
4. Your Privacy Rights
Subject to applicable law and exceptions, you may request access to or copies of records; request corrections; request restrictions on certain uses and disclosures; request confidential communications by reasonable alternative means; request an accounting of certain disclosures; request a paper copy of this Notice; designate an authorized personal representative; and file a complaint without retaliation.
We will honor applicable restrictions on disclosures to health plans when services have been paid in full out of pocket and legal conditions are met. Requests for records maintained through Headway may be coordinated through Headway procedures.
5. Your Choices
Where permitted by law, you may express preferences about sharing information with family members, friends, or others involved in your care. Applicable consent and authorization requirements will be respected, subject to lawful exceptions such as certain emergencies.
6. Additional Protections for Sensitive Information
Mental health records, psychotherapy notes, and other sensitive information may have additional protections under federal or state law.
Substance-use-disorder treatment records protected by 42 CFR Part 2 have additional confidentiality protections, including restrictions on their use or disclosure in proceedings against a patient, except as permitted by applicable law.
Applicable legal restrictions also govern uses and disclosures involving reproductive healthcare information. Information disclosed to recipients outside HIPAA may be redisclosed unless another law restricts redisclosure.
7. Our Responsibilities
Where HIPAA applies, we must maintain the privacy and security of PHI, provide notice of our legal duties and privacy practices, follow the Notice in effect, notify affected individuals of breaches of unsecured PHI as required by law, and make the Notice available upon request.
We may revise this Notice and make revised terms applicable to PHI already maintained by the practice, as permitted by law. Revised notices will be available through our website and upon request.
8. Website Communications and Headway
Our public website provides general information, inquiries, and consultation scheduling; it is not a clinical records portal. Do not send detailed medical or other sensitive information through the general contact form.
Clinical intake, records, telehealth sessions, and billing are primarily managed through Headway. Clients may also be subject to Headway’s applicable Notice of Privacy Practices: https://headway.co/legal/privacy-practices.
Our separate Website Privacy Policy explains how general website inquiries are handled.
9. Privacy Questions and Complaints
Ingredients Therapy Services LLC — Practice Privacy Contact
Email: info@ingredienttherapy.com | Phone: 856-725-1289
You may also complain to the U.S. Department of Health and Human Services Office for Civil Rights: https://www.hhs.gov/hipaa/filing-a-complaint/. We will not retaliate against you for filing a complaint.
10. Availability of This Notice
This Notice is available electronically on our website and in paper form upon request. Clients will receive applicable privacy notices during intake, with acknowledgments handled as required by law.