Bookkeeping for Portland Mental Health Practices
Bookkeeping for Portland therapy and counseling practices. Monthly books, catch-up work, and tax-ready records handled directly by Aretha Dirden.
Bookkeeping for Portland Mental Health Practices
Portland has clinicians everywhere. Second floor suites on Hawthorne, shared offices off Alberta, single rooms rented by the half day in the Pearl, home offices out toward Multnomah Village and Lents. What I hear from Portland practice owners sounds about the same no matter which quadrant they work in. The caseload is full, the clinical work comes first, and the books keep sliding to Sunday night until Sunday night stops being enough.
My name is Aretha Dirden, and I keep the books for mental health practices around the country from my desk in Lancaster, California. Before this I spent more than 15 years as a licensed nurse working in mental health, so when a Portland therapist tells me about no-shows, sliding scale slots, or a supervision hour that got billed oddly, I already know what they mean. Most of the practices I work with are one clinician up to about ten people, and a lot of them are therapists and counselors who never planned on becoming business owners.
Monthly Bookkeeping
Monthly Bookkeeping
Monthly bookkeeping that stays on a rhythm. Transactions categorized, bank and credit card accounts reconciled, and a monthly report you can read between sessions. You’ll know what the practice earned, what it spent, and what’s actually left.
Catch-Up and Clean-Up
Catch-Up and Clean-Up
If nothing has been recorded in a year, that’s catch-up. If it’s been recorded badly, that’s clean-up. Either way I start where you are, get every month reconciled, and hand you books you can believe again.
Payroll and 1099s
Payroll and 1099s
If your practice already has a payroll system running, I can take over processing each pay period so payday stops living in your head. I don’t set new payroll systems up. For associates and supervisors paid as contractors, I prepare year-end 1099s.
Tax-Ready Records
Tax-Ready Records
I don’t prepare tax returns. What I do is make sure your preparer opens a clean set of books in the spring, with categories that make sense for a mental health practice and every account reconciled through year end.
Portland Practices I Work With
Bookkeeping for mental health professionals is the only work I do, so I’m not learning your world on your dime. Portland practices tend to have a particular shape. A lot of private pay and superbills, sliding scale slots held on purpose, a few clinicians licensed in both Oregon and Washington because Vancouver is right across the river, and software subscriptions that quietly add up to real money every month.
Some of the owners who come to me are two years into a practice and have never separated business spending from personal. Others have three associates and no idea which of them is actually profitable. Both are fine starting points. If you’re wondering whether your situation is workable, book a consultation and we’ll talk it through honestly.
Solo Therapists and Counselors
Solo Therapists and Counselors
One clinician, a rented room or a home office, and a practice management system depositing money on its own schedule. I reconcile those deposits to the bank, keep expenses organized, and show you what a full week of clinical hours really brings in.
Group Practices
Group Practices
Practices with associates, an office manager, or a supervisor on contract. Compensation splits recorded correctly, payroll processed on an existing system, and reporting that shows profit per clinician before you commit to hiring the next one.
Telehealth Practices
Telehealth Practices
Online-first practices serving clients across Oregon and beyond. Platform and EHR subscriptions tracked as the real costs they are, merchant processing fees reconciled instead of ignored, and payouts matched to the work behind them.
Recovery and Prescribing Practices
Recovery and Prescribing Practices
Portland has a deep recovery community, and I work with addiction counselors running individual and group sessions at different rates. I also keep books for psychiatric nurse practitioners, which is territory I know from my own nursing years.
Questions About This Area
You're in California and I'm in Portland. How does that work?
The same way it works for my clients in every other state. Everything happens remotely, and you work with me directly rather than a rotating team. Most Portland practice owners I talk with are already used to running a practice from a laptop, so this feels familiar to them.
What does monthly bookkeeping cost?
Full-service monthly bookkeeping starts at $165 a month. The exact number depends on how many accounts you have and how much activity runs through them. I'll give you a real figure after we talk about your practice.
Do you prepare my tax returns?
No, I don't prepare returns. I keep your books tax-ready so your tax preparer has clean, reconciled numbers to work from, including whatever Oregon and Portland area filings apply to you. If you'd like, I'll send your year-end reports straight to them.
My books haven't been touched in over a year. Is that too far gone?
Not at all, and you're in good company. I do catch-up work for practices that are months or years behind, and clean-up work for books that exist but nobody trusts. There's no lecture about how it got this way. We just get it current and keep it that way.
Can you handle my insurance billing or claims?
No. Billing, claims, credentialing, and coding stay with your biller or your practice management system. My part is the bookkeeping side, which means reconciling the deposits that actually land in your bank account and showing you what the practice earned.
Helping the People Who Help Others
Let's Start With
a Short Conversation
Tell me where your books stand right now, even if the honest answer is that nobody has looked at them in a year. I'll ask a few questions and give you a clear idea of how I can help.
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