Health Insurance & Cancellation Policy

Mary Ng Tedjasukmana, LCSW, PLLC


We welcome you to a free initial 15 minute consultation via phone at 718-395-2064 or you may email me at


Out of Network Provider  NOW ACCEPTING NEW CLIENTS

Mary Ng-Tedjasukmana is an Out-of-Network provider. Therapy sessions are typically covered in part by your Insurance Company.  We welcome you to Mary’s office. You  can ask your insurance company about your mental health coverage with an Out of Network provider to see Mrs. Ng. We assist in completing your out of network claim form for you, but full session fee is to be provided at the beginning of each session.

Frequently asked questions for your insurance provider:

1) Do I have mental health insurance benefits that allow for Out-of Network therapy services? If so, what is the coverage amount per session?

2) Does my insurance require that I have pre- authorization prior to sessions with a therapist?  If so, it is your responsibility to have that information prior to our first session.

3) Is there a deductible for Out-of-Network services, and how much has been met?

4) How many sessions per year does my health insurance cover?

5) What credentials does my therapist need to be eligible for reimbursement? Mary Ng-Tedjasukmana is an LCSW.

6) How will I receive my reimbursement and how long will it take ?

7) Is approval required from my primary care physician?





Call TODAY for a free 15 minute Consultation  and Payment scale!

Services as Follows:

Initial Evaluation

Individual Psycho social Evaluation per 90 minutes

Follow up Sessions

Individual session  per  45 minutes
Couples/ Family session per 45 minutes

*payment payable prior to each session

Payment: Cash, check, and all major Debit/ Credit Cards accepted.

Sliding scale:  Available at a very limited basis.

Cancellation Policy: A scheduled appointment is a scheduled appointment. We value your time. In order to maintain continued quality of care and service, should a scheduled appointment need to be rescheduled, please provide 24 hour notice before scheduled appointment time to avoid a full session cancellation fee. This is non-negotiable, and all patients will be required to have a credit card on file for any late cancellations.