Angie Started at 50 with a Credit Card. Two Years Later: 3,000 Patients.

Angie Started at 50 with a Credit Card. Two Years Later: 3,000 Patients.

Angie Janicek worked inpatient psych for 16 years and didn't know psychiatric nurse practitioners existed until 2020. A friend had to tell her. She'd been an RN since 2003, raised four kids (including twins), worked 12-hour shifts, and rotated through military psych units, acute wards, intake, and the ER as a behavioral health assessment nurse. The role she was built for was right in front of her the whole time. She just didn't know it had a name. She went back to school at 45 because her husband had an MBA, her oldest was getting her bachelor's at UT Knoxville, and she realized she was about to have the smallest degree in her own house. That was enough. BSN, then MSN, then DNP from Frontier Nursing University. She opened Premier Psychiatric Services in Goodlettsville, Tennessee in 2024 with her business partner Trey, a credit card, and family members working for free. Her husband John (they've been together since they were 13) managed the books. Trey's wife Brittany quit her respiratory therapy job to answer phones. Nobody got paid for a long time. They hit 1,000 patients in six months. Had to move into a bigger space before their first birthday. They're now past 3,000 patients across a 4,000-square-foot practice, a Spravato clinic for treatment-resistant depression, and a growing ADHD-in-women specialty that Angie is building around the perimenopause and hormonal shift cases nobody else wants to touch. We got into the real numbers: what they spent to open, what they lost on three bad billers before bringing it in-house, why she'd do W-2 over 1099 if she could rewind, the $12-per-chart scribe who changed everything, and why 60% of their referrals come from therapists they visited in person with pamphlets and business cards. She also talked about fighting for NP autonomy in one of the most restricted states in the country and what their senator told them to their faces about why it hasn't passed. If you've been telling yourself you're too far into your career to start over, or too broke to open a practice, or too late to go back to school, Angie went back at 45, opened at 50, and built the thing on a credit card and stubbornness. Her advice is two words: just start.

Inside Carlat Publishing with Dr. Daniel Carlat; a Detailed Discussion with the GOAT.

In this special feature, we explore the deep connection between family legacy and the field of psychiatry. The podcast interview offers a unique perspective on the journey into medicine, showcasing a personal story intertwined with professional dedication. The discussion touches upon aspects of mental health and psychology, providing insight into the motivations behind pursuing a career as a doctor. Before Dr. Daniel Carlat built one of the most trusted names in psychiatric education, he was on Wyeth's payroll promoting Effexor. He stopped when the science didn't hold up, wrote a New York Times piece called "Dr. Drug Rep," and spent the next two decades building an alternative — industry-independent CME that psych NPs and psychiatrists could actually trust. In this conversation, Lindsay and Dr. Carlat cover the real story behind his career shift, why he thinks NP education needs structured residencies, what deprescribing looks like when it's done right (not just political), and how his new AI tool, Ask Carlat, pulls clinical answers from 23 years of unbiased content instead of the open internet. He also drops some blunt advice for any NP who's been approached by a drug rep.

Fired 3 Times, Built a 16-Provider Practice — Dr. Maria Ingalla on Refusing to Run a Pill Mill

Paperflower Institute Courses: https://courses.paperflowerinstitute.com/ [https://courses.paperflowerinstitute.com/] - $50 OFF Coupon Code: LHILL She got fired three times from community mental health jobs for refusing to see patients in 15-minute pill mill rotations. The third time, in October 2020, she had a mortgage, a husband in nursing school, and zero interest in starting a private practice. She did it anyway. Dr. Maria Ingalla is the founder of Paper Flower Psychiatry, a 16-provider, five-location neurodivergent-affirming practice in Arizona. She launched it with about $150 — a $100 website she built herself, a $20 Fiverr logo, and a Psychology Today listing. No loans. No investors. No business plan. Just a refusal to keep getting fired for having ethics. In this episode, Maria and Lindsay get into all of it: how insurance companies deliberately underpay claims by pennies hoping you won't notice (she lost $30,000–$40,000 to Blue Cross before catching it), why she hires virtual assistants directly from the Philippines and pays them fairly instead of going through exploitative agencies, and how she built a nonprofit — Paper Flower Foundation — that pays for psychiatric medications and therapy sessions for patients who fall through the cracks. Maria also talks about why she thinks most psych NP programs are failing their graduates, what she actually looks for in a preceptor application (hint: ditch the professional cover letter), and why she diagnoses autism in adults when other providers are still ruling it out because the patient makes eye contact. She's autistic herself, late-diagnosed, and both of her kids are autistic. And yes, she tattoos herself in her free time. Her dogs are named Marshmallow and Potato. She's been offered millions for her practice and turned it down without thinking twice.

Labs Before Scripts, Supplements Before SSRIs, and a Perinatal Psych Practice That Refuses to Rush | Dr. Kailee Lenczycki, DNP, PMHNP-BC

Kailee Lenczycki and Lindsay used to sell Miss Me jeans together at The Buckle in Beavercreek, Ohio. Now Kailee runs a group psychiatric practice out of Fort Collins, Colorado with five NPs, two full-time admin staff, and in-house billing — and she built most of it while pregnant with her fourth child. In this episode, Kailee walks through the full timeline: a psychology degree from Cedarville, a 13-month accelerated nursing program at Loyola in Chicago, inpatient psych units, a TMS clinic doing clinical research, then four years at North Range Behavioral Health in Greeley where a mentor named Dan France — 52 years in nursing, Florence Nightingale award recipient — gave her the clinical foundation she says made everything else possible. She talks about launching Present Life Psychiatry in March 2024 while still working her W-2 job, spending $3,000–$5,000 on a lawyer and about $2,000 on Silverleaf to set up IntakeQ, doing her own credentialing by going straight to the insurance company websites, and learning billing on one payer before bringing it all in-house. She tried the billing platforms — Headway and others — and left because she couldn't control the customer service. Now her team drops claims, chases denials, and gets 99-plus percent of them paid. She explains why she hired her office manager Sarah — who once sat on the panel that interviewed Kailee for her first NP job — and how she found her first two NPs through a LinkedIn post and a Facebook group. She breaks down why she's firmly W-2 for her providers, what benefits she offers, and how she thinks about the 1099 debate after talking to lawyers. Kailee gets into the integrative psychiatry piece too. She's in the Psych Redefined fellowship with Lindsay, she's running Genome Mind testing on her NPs and her patients (Medicaid covers it at 100%), and she's building weekly case review meetings into the practice culture. She's moving her own clinical focus toward perinatal psychiatry and keeping the practice small on purpose — no 80-patient weeks, no three-month wait lists, direct messaging through Spruce so patients can actually reach their provider. 85% of her referrals come from local therapists she networked with in person. She started the Colorado PMHNPs Facebook group because one didn't exist, and she runs a virtual networking lunch on the second Wednesday of every month. Her son knocked on the door mid-recording. That's the reality. She builds the business from the living room, after the kids are asleep, with her husband working his own job from the next room over. And somehow, a month in Florida with the whole family still worked. Lindsay Hill is a psychiatric NP and coach helping NPs scale freedom and impact.

Starting as a Psychiatric Nurse Practitioner (PMHNP)? Here's What to Expect

Join us for a "day in the life" as we follow a nurse practitioner at a clinic in Colorado Springs. This "nurse vlog" offers a glimpse into the "real world np" experience, providing insights into "nursing" practice. Come to work with me to see the daily responsibilities of a registered nurse in this dynamic setting. No Prior Auth Podcast with Lindsay Hill, DNP, PMHNP-BC. Founder of The Psych NP Fellowship. Private Practice Owner, APNA - AZ Chapter Past President, Co-Founder of The Psych NP Network.