CLINICIAN PROFILE · PMHNP-BC
Josie Desmarais, PMHNP-BC
Psychiatric Mental-Health Nurse Practitioner serving West Palm Beach and all of Florida via telepsychiatry. Founder and sole clinician of Trust Psychiatry & Wellness — medication management + supportive psychotherapy paired in the same visit, in-network with twelve major Florida plans, benefits verified before intake.
ABOUT JOSIE
The clinician you’ll actually see — intake to follow-up.
Josie Desmarais is a psychiatric mental-health nurse practitioner with prescribing authority in Florida, certified as a Diplomate by the American Nurses Credentialing Center. She founded Trust Psychiatry & Wellness because adult outpatient psychiatry in Palm Beach County is overwhelmingly out-of-network or cash-pay — and the patients she trained to serve are the ones quietly priced out of the care they actually have benefits for. The practice closes that gap. In-network with twelve major Florida plans, transparent verification before the first visit, and a clinical model that pairs medication management with supportive psychotherapy in the same appointment rather than splitting them across separate providers.
Her clinical approach is unhurried and evidence-based. First evaluations run 30–60 minutes — long enough to cover medical history, current symptom pattern, prior medication trials, sleep, substance use, family history, and treatment goals without rushing the differential. She prescribes when prescribing is indicated, declines to prescribe when it isn’t, and is direct about which symptoms a medication will likely move and which it won’t. The CBT-informed and mindfulness-informed work she pairs with prescribing isn’t a separate billable hour. It’s a piece of the same visit, because that’s how follow-through actually happens.
Trust Psychiatry & Wellness is adult-only and solo by design. Josie sees every patient herself — no rotating coverage, no chart-reading at the top of every visit, no triangulated communication between a prescriber and a therapist who don’t talk. When something falls outside her scope — child or adolescent work, couples or family therapy, intensive trauma protocols, severe substance-use detox — she says so plainly and refers to West Palm Beach colleagues who specialize in those areas. That clarity, more than any single modality, is what most patients say keeps them with the practice.
CREDENTIALS & LICENSURE
Verifiable, named, and current.
BCBS Florida and Humana are in active credentialing — those members are seen via Trust’s Grow Therapy bridge at in-network rates until direct billing finalizes.
Credentialed and billing in-network with Aetna, Cigna, UnitedHealthcare, Optum, Florida Medicaid, AvMed, Evernorth, TRICARE, M-Care, Cuare, HP, and Paramount.
CLINICAL FOCUS
What Josie treats — named, scoped, and bounded.
Adult psychiatric scope — ages 18 and up. Conditions below are the active clinical focus. Everything outside that list gets a referral, not a workaround.
Depression
Major depressive episodes, persistent low mood, postpartum mood shifts, grief-related depression. SSRI/SNRI-led pharmacotherapy with side-effect monitoring and supportive psychotherapy paired in-session.
Anxiety disorders
Generalized anxiety, social anxiety, panic disorder, work-stress presentations, health anxiety. Evidence-based pharmacotherapy with CBT-informed supportive work in the same appointment.
ADHD
Adult attention, executive function, emotional regulation. Stimulant and non-stimulant trials with structured response measurement and dose-titration across follow-up visits.
Bipolar disorder
Bipolar I, bipolar II, cyclothymic patterns. Mood stabilization with lab monitoring (lithium, lamotrigine, valproate when indicated) and structured episode-prevention planning.
PTSD
Trauma-related symptom management — intrusive memories, hypervigilance, avoidance, sleep disruption. Pharmacotherapy paired with referrals to trauma-specific therapy when EMDR or CPT is indicated.
OCD · Insomnia · Mood disorders
SSRI-led OCD pharmacotherapy with CBT-informed support. Insomnia and circadian-rhythm presentations. Cyclothymia, dysthymia, mixed states, premenstrual dysphoric presentations.
HOW JOSIE WORKS
What’s on the menu, what isn’t.
Medication management leads. Supportive psychotherapy paired in the same visit when it adds clinical value. Patients needing trauma-focused protocols, couples or family work, or specialized therapy modalities get referred — the right clinician matters more than convenience.
Psychiatric Evaluation (30–60 Min)
Initial assessment — history, current symptom pattern, prior medication trials, sleep, substance use, family history, and treatment goals. Working differential by end of visit.
Medication Management (20–30 Min)
Ongoing prescribing visits — SSRIs, SNRIs, mood stabilizers, atypicals, stimulants, non-stimulants. Side-effect monitoring, dosage adjustments, prior authorizations handled in-house.
Med Mgmt + Therapy (45–60 Min)
CBT-informed and mindfulness-informed conversation paired with prescribing — integrated inside the same visit, not handed off to a separate appointment with a separate clinician.
CLINICAL MODEL
How Josie thinks about the work.
Three principles shape every visit — from first evaluation through long-term maintenance.
“Most adults see meaningful symptom improvement within four to eight weeks of starting evidence-based medication management.”
Serotonin receptor downregulation, dopamine pathway titration, and HPA-axis adjustment cycles all peak between weeks 4–8 — which is why Josie waits before judging response and rarely escalates a dose in week 2.
“Medication and supportive psychotherapy belong in the same hour, with the same clinician, on the same chart.”
Split-care models — one prescriber, a separate therapist, no shared notes — create the gaps that erode follow-through. Pairing the work inside one visit removes the triangulation.
“Long-term stabilization typically takes three to twelve months, depending on diagnosis and prior treatment history.”
Symptom reduction is the first marker. Sustained remission, restored sleep architecture, and a steady medication baseline take longer — and they’re the actual outcome Josie tracks at follow-up.
SCOPE & REFERRALS
What Josie does not treat — and where she refers.
Trust Psychiatry & Wellness is an adults-only, medication-management-led outpatient practice. Several presentations belong with clinicians who specialize in them, not with a solo PMHNP managing them as a side scope. The honest list:
- →Children and adolescents (under 18). Referred to West Palm Beach child and adolescent psychiatry colleagues.
- →Couples and family therapy. Referred to licensed marriage and family therapists in Palm Beach County.
- →Intensive trauma-focused protocols (EMDR, prolonged exposure, CPT). Referred to trauma-specialized psychologists when symptom load calls for protocol-driven therapy.
- →Severe substance-use detox or inpatient care. Outpatient MAT/Suboxone for stabilized adults is offered. Acute detox routes to medically supervised facilities.
- →Active psychotic episodes requiring inpatient stabilization. Routed to emergency psychiatric services; outpatient follow-up considered once stabilized.
If your situation falls in any of the above buckets, Josie’s intake will tell you so directly and send named referrals. The referral is the work product when prescribing isn’t.
RELATED CARE
Where Josie’s scope intersects with the rest of the practice.
Six adjacent pages map the specific services and conditions Josie treats. Each opens with the same scope-honest framing and links back here for clinician context.
OUR LOCATION
Visit Josie at 4500 Belvedere Rd, Suite D.
Trust Psychiatry & Wellness
4500 Belvedere Rd, Suite D
West Palm Beach, FL 33415
Hours
Mon–Fri: 9:00 AM – 5:00 PM
Sat: By appointment
Sun: Closed
Free same-building parking · step-free ground-floor entry · Walgreens two doors down for same-visit fills.
View on Google Maps →QUESTIONS FOR JOSIE
What adults ask before booking with Josie.
What’s Josie’s approach to medication trials?
Evidence-based and unhurried. First-line agents (SSRIs for anxiety and depression, stimulants or non-stimulants for ADHD, mood stabilizers for bipolar) start at standard doses with clear side-effect markers to watch and a follow-up scheduled inside 4 weeks. If a medication doesn’t move the symptoms it’s targeting or the side-effect profile is wrong for your life, the plan adjusts or switches — doses don’t escalate indefinitely. Most adults see initial symptom shift within 2–6 weeks; full effect on mood and anxiety agents typically lands at 4–8 weeks.
How long are first appointments — and what should I bring?
First evaluations run 30–60 minutes depending on history complexity. Follow-ups are 20–30 minutes; med-management-plus-therapy visits run 45–60 minutes. Bring a list of every psychiatric medication you’ve previously tried (dose and duration if you remember), current medications including supplements, any recent labs your primary care has on file, and a short note of what you’d like to change. If you’ve had a prior psychiatric diagnosis, the diagnosis itself plus when it was made is useful — the work starts from your symptom presentation today, but history informs the differential.
Does Josie treat adolescents?
No — Trust Psychiatry & Wellness is an adults-only practice (18 and older). For adolescents, Josie is happy to refer you to West Palm Beach colleagues who specialize in child and adolescent psychiatric care. Reach out via the contact form or call (561) 849-4449 and referral options will be sent.
Does Josie work with couples or families?
No. Trust Psychiatry & Wellness is a medication-management-led practice focused on individual adult psychiatric care — psychiatric evaluation, medication management, and supportive psychotherapy paired in the same visit. Couples therapy, family therapy, and marital work fall outside the scope of this practice. Referrals go to licensed marriage and family therapists in Palm Beach County.
Can the whole care plan run via telepsychiatry?
Yes — for Florida residents. Adult patients across all sixty-seven Florida counties can complete the initial evaluation, ongoing medication management, and supportive psychotherapy entirely via secure telehealth. Some patients prefer in-person for the first visit and then move to telehealth; some run the whole arc on video. Either path works, same plan, same fees. Telehealth visits use a HIPAA-compliant secure video platform; state-of-residence verification happens at intake.
Which insurance plans does Josie accept in-network?
Direct in-network billing with twelve Florida plans: Aetna, Cigna, UnitedHealthcare, Optum, Florida Medicaid, AvMed, Evernorth, TRICARE, M-Care, Cuare, HP, and Paramount. BCBS Florida and Humana are in active credentialing — those members are seen via Trust’s Grow Therapy bridge at in-network rates while credentialing finalizes. Benefits get verified before your first visit so the copay is known going in.
How quickly can a new patient be seen?
New evaluations typically open within 10 business days of intake, often sooner if the schedule has a same-week opening. Telepsychiatry slots fill faster than in-person Belvedere Rd slots. If urgency is genuinely time-sensitive, mention that at intake — the schedule has reserved bandwidth for stepped-up evaluations when clinically indicated.
Will Josie continue a medication my previous prescriber started?
Often, yes — if the regimen is appropriate and working. The first evaluation reviews what you’re currently on, what you’ve previously tried, and whether the dose, indication, and monitoring plan match standard-of-care. If everything checks out, the plan continues with refills through Trust. If something needs adjustment, the change happens with you in the room, not by surprise.
SCHEDULE WITH JOSIE
Same clinician, intake to follow-up. Book the evaluation.
In-person at Belvedere Rd or via telepsychiatry across Florida. Benefits verified before your first visit so the copay is known going in. Same-day available.
Same-day available · In-network · New evaluations within 10 business days · Telepsychiatry across Florida