Mu Xu, MD

Amanda Rivera, PMHNP, is a board-certified Psychiatric Mental Health Nurse Practitioner through the lifespan, certified by the ANCC in 2020. She earned a Bachelor of Science in Psychology with a biology minor from Clarkson University, followed by a Bachelor of Science in Nursing and a Master of Science in Nursing from St. John Fisher College. Amanda has over 15 years of experience in mental health, beginning in 2010 as a Therapy Aide at Rochester Psychiatric Center. She has practiced across inpatient hospitals, state psychiatric facilities, outpatient community clinics, correctional settings, group homes, and telehealth/private practice. She works with patients ages 16 and older and is highly experienced in trauma, mood and anxiety disorders, ADHD, autism, psychotic and personality disorders, substance use, and parenting challenges. She values working with families to strengthen the family unit.

Amanda values open communication and collaborates with patients to establish clear, meaningful treatment goals. She provides a warm, supportive environment where patients feel heard, respected, and empowered to take ownership of their mental wellness. Treatment is individualized, with medication decisions guided by a careful balance of safety and symptom relief. Appointments are conversational in nature, allowing care to be more personalized as patients share openly.

Amanda begins each visit by ensuring privacy and safety, then explores the concerns prompting care before gathering a biopsychosocial history through collaborative discussion. She provides education throughout sessions to help patients understand diagnoses and lived experiences. Medication options are discussed based on comfort level and clinical need. Follow-ups are scheduled at the end of each visit, with frequency adjusted as stability is achieved.

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Dr. Mary Lou Gutierrez is board-certified in both Child & Adolescent Psychiatry and General Psychiatry, with over 20 years of clinical experience. She earned her M.D. from Loyola University Medical Center, where she also completed her residency in Adult Psychiatry. She pursued fellowship training in Child and Adolescent Psychiatry at Northwestern University’s Children’s Memorial Hospital. Her past roles include Medical Director for Compass Health Center’s Under 18 Program and Attending Psychiatrist at Loyola. She has been recognized as a “Top Doctor” in Child and Adolescent Psychiatry by US News and World Report and Negocios Now.

Dr. Gutierrez fosters a warm, collaborative environment where patients and families feel supported and understood. She emphasizes open communication and works closely with patients to define meaningful, realistic treatment goals. Her holistic, family-centered approach integrates medication management, therapy, and psychoeducation with a deep commitment to cultural sensitivity and compassionate care.

Dr. Gutierrez begins by learning each patient’s personal story, clinical history, and goals through a comprehensive evaluation. She creates individualized, evidence-based treatment plans tailored to each child’s unique needs and family context. She continuously collaborates with patients, families, and care teams to ensure treatment remains effective, combining psychotherapy, medication management, and coordination with other providers and resources.

Background and credentials

Dr. Shama Milon is a triple-board eligible physician in Pediatrics, Psychiatry, and Child and Adolescent Psychiatry. She earned her undergraduate degree from Duke University and her medical degree from the University of Cincinnati College of Medicine. She completed her combined training in Pediatrics, Psychiatry, and Child and Adolescent Psychiatry at the Icahn School of Medicine at Mount Sinai in New York, where she served as chief resident during her final year of training.

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Treatment approach

Dr. Milon specializes in treating mood disorders, anxiety, PTSD, ADHD, OCD, and patients with co-occurring psychiatric and medical conditions. She is dedicated to outpatient care, focusing on long-term relationships with her patients. Her treatment approach is comprehensive, integrating medication management with psychotherapy, including psychodynamic psychotherapy, cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), play therapy, dyadic therapy, and family therapy. She emphasizes creating an empathetic, judgment-free space where patients and families feel supported and understood. If she believes additional therapy is necessary, she may recommend adding a therapist to the care team.

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What you can expect in a first visit

During the first visit, patients can expect a comprehensive psychiatric evaluation, where Dr. Milon carefully assesses physical, emotional, and psychological needs. She takes a holistic and patient-centered approach, ensuring that treatment plans are tailored to each individual’s unique circumstances. She prioritizes open communication and collaboration with both patients and families to create a structured, effective treatment plan that may include medication management and therapy interventions.

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Why Talkiatry?

We’re a virtual mental health practice that makes it easy to find great care. We combine quality and convenience to help you thrive—faster. Our providers, like this one, are highly trained experts who specialize in medication management and collaborate with you on a treatment plan that fits your needs and comfort level.

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Dr. Mitchell Laski earned a Bachelor of Science in Psychology from the University of Nebraska–Lincoln in 2011 and completed his medical degree at the University of Nebraska College of Medicine in 2017. He completed his residency in psychiatry at Naval Medical Center Portsmouth, Virginia, in 2021, where he was selected as Chief Resident. Dr. Laski has extensive experience in both outpatient and deployed settings, having completed two operational tours with the U.S. Navy. During these tours, he served in Embedded Mental Health Clinics and aboard deployed ships, working directly with Sailors.

Dr. Laski brings empathy, attentiveness, and a non-judgmental approach to every patient interaction. He is deeply committed to ensuring patients feel heard, respected, and understood. Patients can expect him to be thorough and dedicated, consistently advocating for their overall wellness throughout the course of treatment.

Understanding that beginning mental health care can be difficult, Dr. Laski starts with friendly, casual questions to build rapport—asking about patients’ background, interests, and current life situation. He then reviews their medical and psychiatric history before exploring current symptoms and stressors. Together, he and the patient collaborate to create a personalized treatment plan.

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Dr. Nieves-Alvarado is a Board-certified psychiatrist who completed medical training at Duke University Psychiatry Program. Originally from Puerto Rico, she is fluent in both English and Spanish, which allows her to connect deeply with a diverse patient population.

Her practice combines medication management with insight-oriented therapy during every visit, promoting a comprehensive approach to mental health care. She advocates for her patients to engage in therapy alongside medication management, as she believes this integrated approach leads to better outcomes and sustained improvement. Dr. Nieves-Alvarado's practice is rooted in a collaborative, team-based approach, working closely with her patients to achieve long-term mental wellness.

Dr. Nieves-Alvarado earned her medical degree from the Universidad Central del Caribe School of Medicine in Bayamon, PR. Afterward, she moved to North Carolina, where she completed her residency at Duke University Hospital. During her training, she was nominated for a fellowship in psychodynamic practice by the Psychoanalytic Center of the Carolinas, showcasing her expertise in this area. She is also a dedicated advocate against childhood sexual trauma.

Her diverse training includes significant experience in jail and forensic psychiatry, as well as the treatment of military veterans under the veteran affairs health care system. She has experience in medically assisted treatments (MAT) for substance use disorders, Electroconvulsive therapy (ECT), and family therapy, enabling her to care for patients with complex needs.

Dr. Nieves-Alvarado treats patients across a wide age range, from young adults to the elderly. Passionate about improving access to mental health care, she joined Talkiatry to help patients facing time or transportation challenges receive the care they need.  

In addition to her clinical practice, Dr. Nieves-Alvarado remains involved with her alma mater’s Behavioral Health Department, contributing to academic education and maintaining a connection with the next generation of medical professionals. She continues to seek ongoing improvement in her field, remaining engaged with medical associations including North Carolina Psychiatric Association, American Psychiatric Association, and Alpha Omega Alpha national medical honor society. Dr. Nieves-Alvarado is committed to working hand-in-hand with her patients to achieve mental wellness.”

Dr. Ismail is double board-certified by the American Board of Psychiatry and Neurology in both Adult Psychiatry and Child and Adolescent Psychiatry. She earned her medical degree from Cairo University, where she also completed her neurology residency at Cairo University Hospitals. Following this, she pursued psychiatric training at New York Medical College at St. Vincent’s Hospitals, where she was appointed Chief Resident and recognized as Resident of the Year.

Dr. Ismail further specialized with a fellowship in Child and Adolescent Psychiatry at UMDNJ/Rutgers Robert Wood Johnson Medical School. Her career includes multiple leadership roles, notably serving as Chief of the Child and Adolescent Partial Hospital Programs (PHP) at Rutgers University in Newark, NJ, where she provided direct care to young patients. She has also held Medical Director positions across various clinical settings, including child and adolescent inpatient units, outpatient programs, and intensive outpatient services for both adolescents and adults with mental health and co-occurring substance use disorders.

An active educator, Dr. Ismail has been a teaching faculty member, delivering lectures and providing supervision and evaluations for medical residents and child and adolescent psychiatry fellows. Her academic contributions extend to research, where she has served as a principal investigator on multiple studies.

Throughout her career in leadership and teaching, Dr. Ismail maintained an integrative private practice in New Jersey, serving residents of the NJ and NY metropolitan areas before relocating to North Carolina.

Dr. Ismail is passionate about integrative medicine, which combines evidence-based alternative therapies with conventional treatments to optimize outcomes. Her approach focuses on promoting overall wellness, keeping both the body and mind in harmony.

During the diagnostic evaluation, Dr. Ismail will review your medical history and past treatments to develop a comprehensive, personalized treatment plan that prioritizes your overall wellness. In addition to medication management, she incorporates supportive, cognitive, or psychodynamic psychotherapy during follow-up visits, as time allows. When appropriate, she may also recommend referrals to specialized psychotherapists to address your individual needs as part of a holistic treatment approach.