Five different reasons people ring this number. They are answered separately.

A parent calling about a fourteen year old and a person calling about themselves need different first sentences, a different wait, and a different fee. Most practices give everybody the same page. This one does not. Find the paragraph that is about you. Each one says how long the wait actually is and what the hour actually costs, because those are the two facts that stop people dialling and nobody publishes them.

You are calling for yourself.

This is most of the calls. You do not need a diagnosis, a referral, or a reason you can say out loud yet. "I have not been sleeping and I do not know why" is a complete reason to ring, and so is "my father died in March and it is July".

The first appointment is an hour of finding out whether this is the right room. Roughly one person in six decides it is not, and that is a normal outcome rather than a failure. If it is not, you leave with two other names and a note about who takes your insurance, which is worth having even if you never come back.

Wait for a first appointment: 2 to 3 weeksCancellations come up. Ask to be told about them and you will be.
The hour: $140, or $45 to $110 on the scaleSee the scale below. It is not means tested by paperwork.
First step: A ten minute callFree, not a session, and no notes are kept from it.

You are a parent, and the call is about your child.

Say the age first, because it changes everything else. Under twelve, most of the early work happens with the parents in the room and a good deal of it is about the household rather than the child. Twelve to seventeen, the young person is the client, which has a consequence worth knowing before you book: a teenager gets a degree of confidentiality from their parents, and the exceptions to it are explained to everyone, out loud, in the first session.

Schools in Clay, Clinton and Ray counties refer here directly. A school counsellor's note helps and is not required. Neither is a paediatrician's referral, for anything other than an insurance company that demands one.

Wait for a first appointment: 3 to 5 weeksLonger than adults. Under twelve is longer again. This is honest, not a sales tactic.
The hour: $140, same scaleThe parent session that comes with it is not billed separately.
First step: Ring without your child presentThe first conversation is easier for everyone that way.

Two of you are calling, about the two of you.

Couples work here is fifty minutes, both people present, and it does not start with individual sessions. One thing is said plainly at the outset because leaving it unsaid causes most of the damage: this room does not keep secrets between the two of you. Anything told to the counsellor privately can be brought into the room.

Two situations are turned away rather than taken on, and it is better to read that here than to find out in week three. If there is violence in the relationship, joint sessions can make it more dangerous, and the referral is elsewhere. If one person has already decided to leave and wants the sessions to break the news, that is not couples work and it is not fair to the other person.

Wait for a first appointment: 4 to 6 weeksEvening slots are the constraint. Both of you have to be free at once.
The hour: $175Most insurance does not cover couples work. Assume it does not and be pleased if it does.
First step: Either of you ringsThe other is called separately before the first session is booked.

Somebody else sent you. An employer, a programme, or a court.

These calls need a different answer because the question is not really "will this help", it is "what gets reported and to whom". So: an employee assistance programme is told the dates you attended and nothing else, and it is told that in writing which you get a copy of. A court or a probation office is told what its order specifically requires, which is usually attendance and completion, and you are shown the letter before it is sent. Nothing about content leaves this office in either case.

Bring the paperwork to the first session. The number of sessions your programme has authorised is written on it, and it is nearly always fewer than the number the situation calls for, which is a conversation worth having in week one rather than week six.

Wait for a first appointment: Usually within 10 daysMandated referrals carry deadlines and are scheduled around them.
The hour: Billed to the programmeIf it authorises a rate below the fee, the difference is not passed to you.
First step: Send the referral before you ringThen the first call is about scheduling instead of paperwork.

You are in danger tonight.

Then this is the wrong number, and saying so is the most useful thing this page can do. A small practice answers the telephone during office hours and returns messages within a working day. That is a reasonable service and it is no use at all at two in the morning.

Call or text 988. It is answered now, it is free, and it is not the police.

988

The 988 Suicide & Crisis Lifeline is staffed around the clock and you can text it as well as call it. If someone has taken something, or is hurt, call 911 instead. Tri County Mental Health runs the mobile crisis response for Clay, Platte and Ray counties and can come out.

None of that stops you ringing here in the morning. Say on the message that you called a crisis line last night and the appointment is moved forward.

The fee scale, printed, which is the whole argument for a practice this size.

Cost is the reason most people who intend to start therapy never do, and the profession answers the question with "we will discuss it at intake". Here is the answer instead. The band is chosen by you, on the telephone, in about fifteen seconds. There is no application, no pay stub, and nothing to prove.

Per fifty minute session. Six spaces on the two lowest bands are held open at any time, and when they are full you are told so rather than quietly quoted the full fee.
Household income	Individual	Couple	Notes
Under $30,000	$45	$60	Two of the six held spaces sit here permanently.
$30,000 to $50,000	$70	$95
$50,000 to $75,000	$95	$125
$75,000 to $110,000	$115	$150
Over $110,000	$140	$175	The standard fee. Paying it is what funds the bands above.

On insurance, plainly. This practice is in network with two carriers and out of network with everything else. Out of network does not mean you pay everything: most plans reimburse between half and three quarters of the session once a deductible is met, and a monthly superbill is produced for you to submit without being asked. What it does mean is that the money leaves your account first and comes back later, which matters more to most households than the total does. If a deductible has not been touched by July, the scale above is almost always cheaper than using the insurance at all, and you will be told that rather than left to work it out.

Two rooms, one staircase, and a door onto Broadway.

The practice is upstairs in a house from 1921 that has been an office since the sixties. It matters for one practical reason and one human one: there is no lift, and the waiting area is small enough that you will not sit in it with a stranger.

A small counselling room: two armchairs turned slightly toward each other, a lamp on a side table and a tall sash window. — The front room. Two chairs at an angle rather than facing, which is a small thing that makes an hour of talking considerably easier.

A tall wooden sash window with a sheer curtain drawn to one side, a plant on the sill and late afternoon light across a worn wood floor. — West facing, so the four o'clock hour is the warm one and the nine o'clock hour is the plain one.

A small waiting area at the top of a wooden staircase, with two plain chairs, a coat rail, a floor lamp and a closed panelled door. — The landing. Sessions are staggered by ten minutes so the person leaving and the person arriving do not meet, which is not a courtesy in a town of eleven thousand people, it is the point.

A plain painted wooden door on an upstairs landing, closed, with a brass handle and a cast iron radiator beside it. — Closed during a session and there is no light above it, so nobody in the hall can tell whether the room is occupied.

A modest two storey building on a corner, converted to offices, with a plain porch and a path from the pavement. — The building from the pavement. Two steps up to the porch and then a flight of stairs, which is the plain answer to the access question and the reason home visits exist for the people it rules out.

A quiet corner of a small Missouri main street, with two storey brick storefronts, wide empty pavement and an overcast sky. — Broadway, two doors down. Parking is easier than it looks and the meters stop at five.

What actually happens if you ring this afternoon.

The telephone is answered, or it is not.There is no receptionist. Between sessions it rings out. A message left before four o'clock is returned the same day and one left after is returned the next working morning.
Ten minutes, free, and nothing is written down.Enough to hear what is going on and to say honestly whether this is the right place. No file is opened and no record of the call is kept if it does not lead anywhere.
You pick the band and a time.Fee is settled on this call, not at the first session. Evenings run to seven on Tuesdays and Thursdays and they are the first to go.
Two forms arrive by email, or on paper if you prefer.Consent and a history. About fifteen minutes. Bringing them filled in buys back a quarter of the first session, which is worth doing.
The first session, and then a decision that is genuinely yours.At the end of it you are asked whether you want a second one. Not booked automatically, not asked at the door on the way out.

One counsellor. The same one, every week, for as long as it runs.

There is no intake team, no rotating clinician and nobody the work is handed on to. That is the honest trade a practice this size offers against a larger clinic: a longer wait to start, and then the same person for the whole of it.

Telephone

(816) 555-0164

Messages returned within one working day.

Where

214 East Broadway Avenue, upstairs
Excelsior Springs, Missouri
Street parking on Broadway and behind the building

Hours

Monday to Thursday 9 a.m. to 5 p.m.
Tuesday and Thursday until 7 p.m.
Friday 9 a.m. to 1 p.m.
Closed weekends

Tonight

This office is closed and unmonitored outside those hours.
Call or text 988, or 911 if someone is hurt.