Therapy in Montana

I'm Justin Manco, a Licensed Clinical Mental Health Counselor providing telehealth therapy to teens and adults across Montana. I specialize in autism, ADHD, OCD, anxiety, demand sensitivity (PDA), and substance use, especially when several of those are layered together. Montana has a real therapist shortage, especially for specialty work. If you're in Bozeman or Missoula you might find some options, but if you're in Glendive or Miles City or anywhere truly rural, you've probably been told the nearest autism or OCD specialist is hours away. Telehealth changes that.

Who I work with in Montana

My practice focuses on the people whose situation is more complicated than a single diagnosis. That usually means:

• Neurodivergent teens and adults — autism, ADHD, or both, often with anxiety or depression layered on top. I use a neurodivergent-affirming approach, which means therapy that's built around how your brain actually works rather than trying to make you look less neurodivergent.
• People with OCD who need real ERP (Exposure and Response Prevention), done well, including when OCD is tangled with autism or trauma.
• Parents of demand-sensitive kids whose standard parenting tools have stopped working. I co-developed the RELATE framework for Pathological Demand Avoidance (PDA), a structured approach that works with the nervous system instead of against it.
• Adults working through co-occurring conditions — depression, trauma, substance use, or self-harm layered with the above. I've worked across residential, inpatient, PHP/IOP, and outpatient settings, so the full picture doesn't intimidate me.

Telehealth across Montana

I see clients from Bozeman, Missoula, Billings, Helena, Kalispell, and across the rural parts of the state. Because everything happens over secure video, you can do sessions from your home, your car (parked, obviously), your office, or anywhere with a private space and a decent connection. For a lot of my clients — especially autistic and ADHD folks — being able to stay in their own regulated environment makes the therapy work better, not worse.

Common cities I see Montana clients from include Bozeman, Missoula, Billings, Great Falls, Helena, Kalispell, Butte, Belgrade, Whitefish, Livingston. But if you're in a smaller town, a rural area, or a part of the state I didn't name, telehealth works there too.

Insurance and private pay in Montana

In Montana, I'm in-network with Aetna, Cigna, Evernorth, BCBS Montana affiliates, Carelon, Medica, and other major plans through Tava Health. When you click Book Now, you'll land on my Tava Health profile, where you can check your specific insurance plan in about 30 seconds and see your expected out-of-pocket cost before you commit to anything.

If you don't have insurance or prefer private pay, the rate is $150 per session.

What Montana clients usually ask

Is telehealth legal in Montana?

Yes. I hold a license that lets me provide telehealth therapy to Montana residents, and all sessions happen over a HIPAA-compliant video platform. You need to be physically located in Montana (or one of the other three states I'm licensed in) when we meet, but otherwise there are no geographic restrictions within the state.

Do you only see clients in Montana?

No. I'm also licensed in Utah, Colorado, Montana, and Texas. If you're a Montana resident who travels or moves to one of those states, we can keep working together without interruption.

How soon can I start?

Usually within a week. I don't run a waitlist. Book directly through Tava and you'll see my real availability for the next two weeks.

Ready to start?

Book your first session through Tava Health. You'll be able to verify your insurance, pick a time that works, and meet with me from wherever you are in Montana. If you have questions before booking, email me at rockymountaincwc@gmail.com and I'll respond directly.

If you want to read more about how I work, the specialties page goes into more depth on each condition, and the about page has more background on my clinical experience and the RELATE framework. For parents in crisis considering higher levels of care, the treatment navigation page describes the 90-minute consultation service I offer for families evaluating residential treatment, PHP, or IOP.