Ruben Mendez, MD

Dr. Michael Fiori is Board Certified in Adult Psychiatry and Addiction Medicine. He has practiced general psychiatry for 37 years, and has also sub-specialized in Addiction Psychiatry for the past 20 years. Dr. Fiori's practice emphasizes Diagnostic Clarification, which is an ongoing process. He is highly trained and experienced in the biological and psychosocial underpinnings of psychiatric problems. He typically follows diagnostic evaluations with 30-minute follow up visits for medication adjustments and brief therapy. Dr. Fiori often enjoys collaborating with outside therapists when needed. Dr. Fiori graduated from Amherst College and received his medical degree from NY Medical College. He subsequently completed his residency in psychiatry at the Mount Sinai Medical Center in NYC. He excelled in Academic Psychiatry as both a teacher and a mentor. His practice has always combined medications with evidence-based therapies to alleviate suffering and maximize functioning. In addition to his work as a Board Certified Adult Psychiatrist, he has specialized in helping patients suffering from Substance Use Disorders. Dr. Fiori is Board Certified in Addiction Medicine, and helps patients understand the interrelationships between their Substance Use Disorders and their Psychiatric illnesses.

Megan is a Board-Certified Psychiatric Mental Health Nurse Practitioner specializing in medication management and various therapeutic techniques. She earned a Master of Science in Nursing as a Psychiatric Nurse Practitioner from Regis College and has board certification from the American Nurses Credentialing Center (ANCC).

Megan has extensive experience in psychiatric settings, including private practice, inpatient facilities, and substance use treatment programs. She has worked on community initiatives, such as the Mobile Suboxone Van program, which provides treatment to individuals in high-need areas.

She utilizes evidence-based practices in treating clients with mood and anxiety disorders, ADHD, trauma, and substance use disorders, among other mental health disorders.

The first priority is establishing a therapeutic relationship and providing adequate support, which can substantially impact outcomes. The combination of medication management and therapy can effectively reduce symptoms and contribute to the remission of mental health symptoms.

The first session will involve a 60-minute psychiatric evaluation to gather history and discuss current symptoms and goals. Clients starting medication will need more frequent 30-minute follow-up appointments for medication management and therapy, ensuring a positive response to treatment.

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Dr. Natalie Cummings is a board-certified adult psychiatrist, and board-eligible geriatric psychiatrist. She obtained her medical degree from the University of North Carolina at Chapel Hill, and completed her residency training in psychiatry at the University of Miami Miller School of Medicine and Jackson Memorial Hospital. She then went on to complete her geriatric psychiatry fellowship at Icahn School of Medicine at Mount Sinai Beth Israel. During her fellowship, Dr. Cummings participated in Mount Sinai's Visiting Doctors Program, providing patient-centered and compassionate care to homebound elder adults in New York City. She also received training at Coler Rehabilitation and Nursing Care Center on Roosevelt Island during her fellowship, and presented at the American Association for Geriatric Psychiatry annual meeting. During her training, Dr. Cummings gained extensive experience providing psychiatric care to various patient populations in multiple patient care settings, including in the outpatient clinic, inpatient unit, and emergency department. Following her training, Dr. Cummings worked at New York Presbyterian's Gracie Square Hospital, serving first in the position of float psychiatrist, providing care to patients on every inpatient psychiatric unit (including the young adult/college student program, Orthodox Jewish program, psychotic disorders program, crisis-stabilization program, dual focus program, and Asian Psychiatry program), before transitioning to an established psychiatric attending for the older adult program. During her time at Gracie Square Hospital, Dr. Cummings received the Physician of the Year Award, and served as a Clinical Assistant Professor of Psychiatry at Weill Cornell Medicine. She worked closely alongside staff psychologist, social workers and nurses to provide multidisciplinary, collaborative care to patients suffering from a variety of mental health conditions. Dr. Cummings primarily focuses on medication management and supportive psychotherapy, but has extensive training in utilizing various therapy modalities, including cognitive behavioral therapy, interpersonal therapy, reminiscence therapy, and psychodynamic psychotherapy. When appropriate, Dr. Cummings will refer for more extensive psychotherapy and/or collaborate with your established psychotherapist for comprehensive care. Dr. Cummings strongly believes that addressing psychosocial and interpersonal factors (including relationship health, economic stressors, social isolation and loneliness) is as essential as pharmacologic management in treating mental health conditions. She has particular experience and interest in treating older adults and those suffering from memory disorders, but provides treatment for a variety of psychiatric conditions including depression, anxiety, bipolar disorder, obsessive-compulsive disorders, trauma-related disorders and substance use disorders. Dr. Cummings is a member of the American Psychiatric Association and American Association for Geriatric Psychiatry.

Dr. Dominic Adams earned his medical degree from Eastern Virginia Medical School and completed his residency at the University of Mississippi Medical Center. He has experience treating a broad range of mental health conditions using both medicinal and psychotherapeutic interventions. Dr. Adams works with children, adolescents, and adults, and has training in cognitive behavioral and psychodynamic psychotherapy.

Dr. Adams strives to create a cooperative therapeutic experience that fosters open and empathetic communication. He values patient choice in treatment and prioritizes empowering patients through psychoeducation. Drawing on a variety of psychotherapeutic techniques, he tailors care to meet the unique needs of each individual.

Initial appointments with Dr. Adams include a thorough review of the patient’s concerns and the development of both patient and physician treatment goals. He discusses treatment options in detail, providing education on any medications, therapies, or interventions. Together, he and the patient select a dynamic treatment plan and set a follow-up schedule to monitor progress.

Dr. Ioana Horotan-Enescu is a board-certified Psychiatrist. Before joining Talkiatry, she was an Active-Duty staff psychiatrist at Blanchfield Army Community Hospital, Fort Campbell, KY. Her military service also included roles such as Medical Director of Behavioral Health and Interim Clinic Chief for Embedded Behavioral Health Clinic. She completed her internship and residency at Walter Reed National Military Medical Center and earned her Doctor of Osteopathy Degree from the University of New England College of Osteopathic Medicine. Her clinical experience spanned from the inpatient to the outpatient setting and afforded her the opportunity to develop comprehensive skills in the treatment of PTSD, mood disorders, thought disorders, addiction and perinatal mood disorders. Her teaching experience spanned multiple institutions, where she has served as a preceptor and mentor for medical students, nurse practitioner and physician assistant students. In addition to medication management, she augments her practice by implementing mindfulness, psychodynamic and supportive therapy techniques in her everyday practice to enhance treatment and improve treatment response. Dr. Horotan-Enescu holds several certifications, including in Cognitive Behavioral Health Therapy for Suicide Prevention, Motivational Interviewing and Battlefield Acupuncture. She has delivered presentations at national and international conferences on various topics, reinforcing her commitment to advancing the field of psychiatry.

Roel Sepulveda is a board-certified psychiatric mental health nurse practitioner (PMHNP-BC) with a Master of Science in Nursing from the University of Alabama at Birmingham. Certified by the American Nurses Credentialing Center (ANCC), he has over 10 years of experience providing mental health care in psychiatric emergency rooms, outpatient psychiatry, and telehealth settings. Roel is committed to delivering comprehensive and accessible care that supports patients across diverse needs and backgrounds.

As a provider, Roel values creating a compassionate and collaborative environment where patients feel comfortable sharing their experiences. He takes a patient-centered approach, meeting individuals where they are and working together to identify treatment goals. Patients can expect a nonjudgmental space where their concerns are heard, respected, and addressed with empathy and understanding.

When working with patients, Roel begins by taking time to understand their history, symptoms, and current challenges. He develops individualized treatment plans that may include a combination of medication management, lifestyle strategies, and coordination with therapy or other supports. His goal is to provide evidence-based care while empowering patients to actively participate in their mental health journey and achieve lasting well-being.