Good Faith Estimate

Effective Date: [Date]

Under Section 2799B-6 of the Public Health Service Act, healthcare providers must provide a Good Faith Estimate of expected charges to uninsured or self-paying clients.

Provider Information:

  • Mariana Enson, AMFT #161253

  • Supervised by Tamar Colen, LMFT #22944

  • 2615 Pacific Coast Hwy #324, Hermosa Beach, CA 90254

  • Phone: 424-236-2060

  • Email: marianaenson@gmail.com

Services Offered:

  • Individual Therapy: $175 per 50-minute session

  • Couples Therapy: $175 per 50-minute session

  • Family Therapy: $175 per 50-minute session

  • EMDR Therapy: $175 per 50-minute session

Estimated Treatment Duration: The length of treatment varies based on individual needs and goals. Some clients work with me for a few months, while others continue for a year or more. We will regularly review your progress and discuss your treatment plan.

Estimated Total Cost:

  • Short-term therapy (8-12 sessions): $1,400 - $2,100

  • Moderate-term therapy (6 months/24 sessions): $4,200

  • Long-term therapy (1 year/48 sessions): $8,400

These are estimates only. Actual costs will depend on your specific treatment needs and frequency of sessions.

Payment & Insurance:

  • Payment is due at the time of service

  • Sliding scale fees available on a limited basis

  • Superbill provided for out-of-network insurance reimbursement

  • I am not in-network with any insurance providers

Your Rights: You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill through the federal dispute resolution process.

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