Notice of Privacy Practices
East Nashville Counseling Location and Online for Clients in TN & VA
Tim Jackson Counseling
Tim Jackson Therapy LLC
1530 Riverside Drive, Nashville, TN 37206
615-200-8734
timjacksoncounseling.com
NPI: 1881428308
Effective Date: August 1, 2026
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Overview
Tim Jackson Counseling is committed to protecting the privacy of your health information. We create and maintain records of the care and services you receive in order to provide quality care and comply with applicable legal requirements. This Notice describes how we may use and disclose your Protected Health Information (PHI), your rights regarding that information, and our obligations under the Health Insurance Portability and Accountability Act (HIPAA).
This Notice applies to all records of care generated by Tim Jackson Counseling. By receiving services, you acknowledge receipt of this Notice.
Our Legal Obligations
Tim Jackson Counseling is required by law to:
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Maintain the privacy of your Protected Health Information (PHI)
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Provide you with this Notice of our legal duties and privacy practices
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Follow the terms of the Notice currently in effect
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Notify you if there is a breach of your unsecured PHI
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Update this Notice when our practices change — updates apply to all information we hold about you and are available upon request
What Is Protected Health Information (PHI)?
PHI includes any information that identifies you and relates to your health, the care you receive, or payment for that care. This includes information about your symptoms, treatment, diagnosis, and any personal identifying information connected to your healthcare.
How We May Use and Disclose Your Health Information
Your health information will not be shared with any individual or entity without your written authorization, except in the following circumstances:
Without Your Authorization
Treatment: We may share your information with other healthcare providers involved in your care in order to coordinate treatment.
Payment: We may use or disclose your health information as necessary to obtain payment for services provided to you. Note: Tim Jackson Counseling is a private pay practice and does not bill insurance for new clients.
Appointment Reminders: We may contact you with appointment reminders via email, text, or voicemail.
Duty to Protect: If we determine that you are at risk of serious harm to yourself or another individual, we are legally and ethically obligated to take appropriate action, which may include contacting law enforcement or other individuals necessary to prevent that harm.
Mandatory Reporting: We are required by law to report suspected abuse or neglect of a child or of any individual who is unable to protect themselves due to age, disability, or other circumstances.
Legal Requirements: We may disclose your health information when required by a valid court order. We will take all reasonable steps to protect your confidentiality in such circumstances.
Emergency Situations: In the event of a medical emergency, we may disclose relevant information to family members or others involved in your care.
With Your Written Authorization
Any use or disclosure of your PHI not described above requires your written authorization. You may revoke that authorization at any time in writing, except where we have already acted in reliance on it.
Your Rights Regarding Your Health Information
Right to Access: You have the right to inspect and obtain copies of your health information. Requests must be made in writing. A reasonable fee may be charged to cover labor, copying, postage, or other related costs.
Right to Amend: You have the right to request a correction to your health information if you believe it is inaccurate or incomplete. We may deny this request under certain circumstances and will explain the reason in writing.
Right to an Accounting of Disclosures: You have the right to request a list of disclosures we have made of your PHI, with certain exceptions.
Right to Request Restrictions: You have the right to request restrictions on how we use or disclose your PHI. We are not required to agree to all requests, but we will consider them.
Right to Confidential Communications: You have the right to request that we communicate with you by alternate means or at an alternate location. We will accommodate reasonable requests.
Right to a Paper Copy of This Notice: You have the right to a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
Questions and Complaints
If you have questions about your privacy rights, believe your rights have been violated, or wish to file a complaint, you may contact us directly:
Tim Jackson Counseling
1530 Riverside Drive, Nashville, TN 37206
615-200-8734
You also have the right to file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights without fear of retaliation:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-877-696-6775
www.hhs.gov/ocr/privacy/hipaa/complaints
Changes to This Notice
We reserve the right to change the terms of this Notice at any time. Changes will apply to all health information we maintain. An updated Notice will be made available upon request and posted at timjacksoncounseling.com.