Psychiatrists often practice psychotherapy, but they are also doctors—that is, they have earned a medical degree. Our team also includes nurse practitioners that are registered nurses with advanced nursing education and training in the diagnosis and management of common psychiatric illnesses. This expertise allows the psychiatric team to more profoundly understand the medical scope of a patient’s trouble and prescribe medications if it is an appropriate treatment.

The psychiatric team at NRVCS provides a comprehensive array of recovery-oriented mental health and chemical dependency services. The team includes a medical director, 3 full-time adult psychiatrists, 2 part-time child and adolescent psychiatrists and 2 full-time nurse practitioners. NRVCS also contracts with other physicians and nurse practitioners from time to time to augment our services.

Treatment Philosophy
Psychiatric Services at NRVCS adhere to core mission of the agency and are based on principles of:

- Team Approach
- Recovery Orientation
- Confidentiality
- Professional Standards of treatment

Services Provided
Most of the services are provided in conjunction with our colleagues who provide psychotherapy, case management and mental health support services. Our doctors do not always prescribe medication. The doctor/NP will see a patient for an initial evaluation, after which he or she will recommend medication treatment only if it is appropriate. Generally, patients are expected to follow up with counseling services or case management/mental health supports in between doctor/NP visits.

Referrals
Referrals are accepted through our ACCESS service by calling 540-961-8400. If you are already seen by another provider in the agency and would like to see a psychiatrist or NP then please talk to that person or your therapist/case manager.

MEET OUR TEAM

J. Bobby Miglani, M.D., FAPA: Medical Director: Dr Miglani is a graduate of Christian Medical College in India. He finished his internship at University of Vermont and completed psychiatry residency at University of Virginia School of Medicine, Roanoke - Salem Psychiatric Medicine Program.

Teresa Rose-Thornton, RN: Teresa is coordinator for NRVCS Psychiatry Service and manages the operations of the team of case managers, nurses and care coordinators attached to the Psychiatric Service.

Melissa Tickle-Bond, APRN-C, PMHNP: Ms. Tickle-Bond is a graduate of nurse practitioner program of Vanderbilt University. Prior to joining NRVCS she worked in the inpatient unit of Lewis Gale Psychiatric Center.

Circe Cooke, M.D.: Dr Cooke is a graduate of MD program at University of New Mexico. She finishes a triple board residency in general psychiatry, child/adolescent psychiatry, and pediatrics at University of Kentucky.

Michelle Frieben, M.D.: Dr Frieben is a graduate of University of Rochester Medical School. She finished her residency at University of Wisconsin and University of Virginia.

Patti Sandoe MSN, FNP: Ms Sandoe is a graduate of Radford University BSN program. She obtained her MSN from University of Virginia and later did her Post-masters Family Nurse Practitioner degree at Virginia Commonwealth University/Medical College of Virginia. She has 25 years of experience in nursing with practice in nursing education and family medicine.

Paul DeLapp, M.D.: Dr DeLapp is a graduate of Eastern Virginia Medical School and he finished residency at University of Virginia School of Medicine, Roanoke - Salem Psychiatric Medicine Program. He also has masters in Exercise Physiology from Old Dominion University.

Varuna Joshi, M.D.: Dr Joshi finished her medical schooling at Dayanand Medical College in India and graduated psychiatric residency from Carilion Clinic program in Roanoke, VA.