Wayne McIntosh, PMHNP

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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Trudy Warner-Phillips, PMHNP, is a board-certified psychiatric nurse practitioner with over 25 years in nursing and 7+ years in psychiatric care. Her experience spans outpatient, inpatient, and telehealth settings, where she treats conditions such as anxiety, depression, PTSD, mood disorders, and ADHD. She is passionate about delivering thoughtful, evidence-based care in a supportive and accessible virtual environment.

Trudy’s approach is grounded in trust, respect, and collaboration. She values open, honest communication and aims to create a space where clients feel heard, safe, and empowered. By understanding each person beyond their symptoms, she tailors care to support individual challenges, strengths, and goals.

Initial sessions involve a thorough assessment of medical and psychiatric history, current concerns, and past treatments. Trudy then works with clients to develop a personalized care plan focused on their most pressing symptoms. Her treatment may include medication management, supportive therapy, and lifestyle recommendations to promote lasting emotional well-being.

Dr. Caitlin Gardiner is a board-certified psychiatrist specializing in child and adolescent psychiatry and psychotherapy. Dr. Caitlin Gardiner's practice is based on the biopsychosocial model and believes that the foundation of healing is in psychotherapy and human connection. She is known for incorporating therapy into her medication management practice. Typically she offers 30-minute follow-up visits for medication management with focused therapy based on individual needs. As a known helper, Dr. Gardiner started her career with a bachelor's degree in social work from Cazenovia College in Cazenovia, NY. After changing career paths, she received her medical degree from SUNY Upstate Medical University in Syracuse, NY. She stayed upstate to complete her general psychiatry residency, where she was chief resident at the beginning of the COVID-19 pandemic. Following this, she completed her child and adolescent psychiatry fellowship at Upstate due to the high quality of training. Dr. Gardiner has completed 3 years of advanced training in Dynamic Deconstructive Psychotherapy as well as specialized training in DBT. Dr. Gardiner is a well-rounded psychiatrist who enjoys treating youth and young adults during transitional phases of life while providing a safe and supportive environment. She believes strongly in reducing polypharmacy and providing high-quality medication management through a therapeutic and developmental lens.

Dr. Steve Paschos is a board-certified Psychiatrist at Talkiatry. He attended Loyola University Chicago on the Lake Shore campus, completing a bachelor's degree in science and a Degree in Classical Studies. He then attended Medical School at Rush Medical College in Chicago and completed a 5-year combined Internal Medicine & Psychiatry residency in 2011. Dr. Paschos subsequently completed a 1-year fellowship in Geriatric Medicine at Rush University Medical Center. He has spent the last 12 years fulfilling his passion for integrating Internal Medicine & Psychiatry, working with a diverse range of patients suffering from severe mental illnesses. ‍Dr. Paschos' years of experience have included working at Cook County Health Services � Cermak Health Services at Cook County Department of Corrections with an extremely diverse patient population with varying psychiatric illnesses. He has also worked as an inpatient psychiatric hospitalist and as the director of the Intensive Care Unit at Chicago Behavioral Hospital in Illinois. Dr. Paschos also acted as a medical director of an IOP and established an outpatient psychiatric practice in conjunction with the Intensive Outpatient Program. He has had the opportunity and privilege of treating individuals who suffer from various diagnoses, especially challenging patients who have suffered from integrated or Med-Psych concerns involving primary mood disorders, Bipolar Affective disorders, prior trauma, severe medical problems/diagnoses along with concurrent personality pathology. ‍Dr. Paschos utilizes supportive psychotherapy, brief cognitive behavioral therapy, and at times psychodynamic therapy to address his patients' current complaints and to identify the locus of their symptoms. He believes in utilizing an all-encompassed approach using mindfulness and various psychotherapies along with comprehensive medication management. To quote Hippocrates "Where there is love for the art of medicine there is a love of humanity.”

Dr. Sara Mateo holds the position of staff Psychiatrist at Talkiatry. She is a board-eligible adult Psychiatrist. Dr. Mateo completed her Medical degree at the University of Benghazi- Faculty of Medicine and finished General Psychiatry Residency training at Tower Health/DrexelPhoenixville Hospital. Throughout her career, Dr. Mateo has actively contributed to various leadership roles and committees, demonstrating her commitment to advancing medical education and promoting diversity in the field. During her training, she generously shared her knowledge through educational presentations and lectures, fostering the growth of fellow trainees and medical students. Dr. Mateo is dedicated to creating a therapeutic environment characterized by warmth, empathy, and nonjudgmental support. Her approach involves collaborating with patients to develop individualized treatment plans that consider cultural, biological, psychological, and social factors. With a primary focus on medication management, Dr. Mateo's keen interest in psychotherapy is evident, as she often integrates supportive therapy, cognitive behavioral therapy, and psychodynamic psychotherapy during 30-minute follow-up visits to optimize wellness and recovery. Dr. Mateo brings a wealth of experience in caring for individuals of diverse ages and backgrounds, adeptly addressing a wide spectrum of conditions. Her expertise extends to treating depressive disorders, bipolar disorders, anxiety disorders, trauma and stress related disorders, ADHD, OCD, Insomnia, psychotic disorders; she also has experience treating individuals with medical comorbidities.

Background and credentials  

Dr. Alexandra Baluna, MD, is board-certified by the American Board of  Psychiatry and Neurology. She received her medical degree from  LSUHC-Shreveport and completed her psychiatry residency training at  Montefiore/Albert-Einstein College of Medicine, where she served as chief of  the Consultation-Liaison (C/L) service. Following residency, Dr. Baluna  served as Senior Chief, during which she was honored with the Leo M. Davidoff  Award for Outstanding Achievement in the Teaching of Medical Students. Her  professional experiences include roles at Fordham University, Albert Einstein  Student Mental Health Counseling Center, and most recently, as an outpatient  psychiatrist at Maimonides Medical Center, where she enjoyed teaching and  supervising residents.  

Treatment approach  

Dr. Baluna emphasizes creating a warm, empathic, and nonjudgmental  therapeutic environment. She collaborates closely with patients to develop  personalized treatment plans that consider cultural, biological,  psychological, and social factors. With a strong interest in psychotherapy,  she frequently employs ego-supportive and insight-oriented therapy techniques  during follow-up sessions.  

What you can expect in a first visit    

During an initial visit, patients can expect a welcoming and supportive  atmosphere where Dr. Baluna conducts a comprehensive assessment. This  involves exploring the patient's history, current challenges, and individual  circumstances. The goal of the first session is to collaboratively build an  individualized treatment plan tailored specifically to the patient's unique  needs.  

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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 speciualize in  medication management and collaborate with you on a treatment plan that fits  your needs and comfort level.