Notice of privacy practices
Christie Kim Mental Health Counseling PLLC
Effective Date: August 1, 2026
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. 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.
My Commitment to Your Privacy
I am committed to protecting information about your health and care. This notice applies to all of the records of your care generated by this mental health care practice. I am required to maintain the privacy of your protected health information (PHI), to provide you with this notice of my legal duties and privacy practices, and to abide by the terms of this notice while it is in effect.
How I May Use and Disclose Your Health Information
For Treatment. I may use or disclose your PHI to provide, coordinate, or manage your treatment, including consulting with other treating professionals about your care.
For Payment. I may use or disclose your PHI to obtain payment for services, including providing a superbill for insurance reimbursement you seek directly.
For Health Care Operations. I may use or disclose your PHI for activities such as quality assessment, licensing requirements, or professional consultation regarding your care.
As Required or Permitted by Law. I may, or in some cases must, disclose your PHI without your authorization in the following cases:
When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
I believe you present a serious and imminent danger to yourself or another person.
For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
Disclosure is required by a court order or other lawful legal process, including responding to a court or administrative order or subpoena, although my preference is to obtain an Authorization from you before doing so.
For my use in training or supervising associates to help them improve their clinical skills.
Disclosure is required for public health, health oversight, or safety purposes as defined by law (e.g., reporting to state licensing boards).
5. I will not use or disclose your PHI for marketing purposes. I will not sell your PHI.
Your Rights Regarding Your Health Information
Right to Request Restrictions. You may ask me to limit how I use or disclose your PHI. I am not required to agree to your request, and I may say “no,” for example if I believe it would affect your health care. If I agree to your request, I may still share this information in the event that you need emergency treatment.
Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. If you pay for a service or health care item out-of-pocket in full, you can ask me not to share that information for the purpose of payment or operations with your health insurer. I will agree unless a law requires us to share that information.
Right to Request Confidential Communications. You may ask that I contact you in a specific way or at a specific location.
Right to Inspect and Copy. You may review or obtain a copy of your PHI, with limited exceptions. Psychotherapy notes are held to a higher protection standard under HIPAA, are maintained separately from your clinical record, and are not accessible through this right. I will provide you with a copy of your record or a summary of your health information following a written request, and I may charge a reasonable, cost based fee for doing so.
Right to Amend. You may request an amendment to your PHI if you believe it is incorrect or incomplete. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.
Right to an Accounting of Disclosures. You may request a list of certain disclosures of your PHI made outside of treatment, payment, and operations, in the six years prior to the date of your request, unless you request a shorter time period. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost based fee for each additional request.
Right to a Paper Copy. You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.
Right to be Notified of a Breach. You have the right to be notified if a breach of your unsecured PHI occurs.
Complaint Rights
If you believe your rights have been violated or you have concerns about my practice, you can contact me directly at christie@ckimtherapy.com to discuss concerns. You may also file complaints with your state licensing board and/or Office for Civil Rights as listed below. Filing a complaint will not affect your treatment in any way.
New York State Education Department, Office of the Professions
Texas Behavioral Health Executive Council
U.S. Department of Health and Human Services Office for Civil Rights (HIPAA violations)
Psychotherapy Notes
I may maintain psychotherapy notes separately from your clinical record. These notes receive additional protection under HIPAA and are generally not disclosed without your specific written authorization, except as permitted or required by law.
Substance Use Disorder Records
If we receive or maintain records about you that are subject to federal substance use disorder confidentiality protections under 42 CFR Part 2, we will handle those records in accordance with applicable federal and state law.
Changes to This Notice
I reserve the right to change this notice and to make the revised notice effective for PHI I already maintain, as well as any I receive in the future. An updated notice will be provided to you and made available upon request.
Contact Information
Questions about this notice or your privacy rights may be directed to: Christie Kim, LMHC, LPC, at christie@ckimtherapy.com.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html