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Good Faith Estimate
Empower Counseling Center

Effective Date: March 24, 2026

You have the right to receive a “Good Faith Estimate” explaining how much your mental health care will cost.

Under the No Surprises Act, healthcare providers are required to provide clients who do not have insurance or who are not using insurance (self-pay clients) with an estimate of the expected charges for healthcare services, including mental health services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency mental health services, including psychotherapy services such as intake assessments, individual therapy, family therapy, and group therapy.

You can ask your healthcare provider for a Good Faith Estimate before you schedule a service or at any time during treatment.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.

You may contact the U.S. Department of Health and Human Services (HHS) to begin a dispute resolution process. You must start the dispute process within 120 days (4 months) of the date on the original bill.

If you dispute your bill, the provider cannot move the bill into collections or threaten collections while the dispute is ongoing.

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


Mental Health Services Covered

Mental health services at Empower Counseling Center may include:

  • Initial intake assessment
  • Individual psychotherapy
  • Family therapy
  • Group therapy

Fees vary depending on the provider and type of service. You will be informed of session fees prior to scheduling services, and a Good Faith Estimate can be provided upon request or at the time of scheduling.

Actual charges may differ if additional services are recommended, if treatment needs change, or if unforeseen circumstances arise.

This Good Faith Estimate notice applies to mental health and psychotherapy services. Other professional services such as supervision, consultation, training, or speaking services are not considered healthcare services under the No Surprises Act and are not included in Good Faith Estimate requirements.


Contact Information

If you have questions about your Good Faith Estimate or would like to request one, please contact us:

Empower Counseling Center
4411 Suwanee Dam Road #450
Suwanee, GA 30024
Phone: (877) 693-8386
Email: hello@empowercounseling.net
Website: empowercounseling.net

Empower Counseling specializes in EMDR therapy for complex trauma, offering affirming care for neurodivergent and LGBTQ+ clients. Our therapists help smart, sensitive overachievers who feel stuck, burned out, or like something always seems to get in the way through trauma therapy, EMDR therapy, and anxiety counseling.

Areas we serve: Therapy is available in person in Suwanee, serving Gwinnett County and the North Atlanta area, and online across Georgia, Florida, Virginia, and Illinois.

Empower Counseling Center, LLC
4411 Suwanee Dam Rd, #450 | Suwanee, GA 30024 
Call or Text: (877) 693-8386 | Fax: 770-727-8786 | Email: hello@empowercounseling.net

© 2026 Empower Counseling Center LLC. All rights reserved.