OUR PROVIDER
Meet Our Medical Provider
Julius Guiang, PMHNP-BC
Julius Guiang is a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) with a diverse and distinguished background in both military and civilian healthcare. He began his medical career as a Navy Hospital Corpsman, honing his clinical and emergency response skills as an Emergency Department Technician. He later served with the U.S. Marine Corps as a field medic, where he trained extensively in infantry tactics and emergency field medicine.
Following his honorable military discharge, Julius pursued his nursing education, earning his Bachelor of Science in Nursing degree from Hawaii Pacific University. He worked as an emergency/ trauma nurse for several years, delivering critical care to diverse populations, such as veterans, homeless individuals, racial/ ethnic minorities, geriatric populations, and children.
This cumulative experience in the medical field in both the military and civilian sectors have provided Julius with the insight that mental health continues to be a stigmatized and overlooked aspect of health across various populations. Driven by a deep interest in mental health, Julius completed his Master of Science in Nursing degree, specializing as a Psychiatric Mental Health Nurse Practitioner at the University of Texas at Tyler.
Julius believes that in order to achieve overall health and wellness, it is important to consider that the mind and body are connected. By helping to address issues concerning mental health, Julius hopes to help improve his patients’ quality of life through comprehensive mental health treatment.
My Approach to Care
I strive to create a calm, collaborative environment where patients feel heard, respected, and supported.
Treatment is never one-size-fits-all.
I focus on:
Comprehensive evaluations
Clear, structured treatment plans
Thoughtful medication management
Ongoing collaboration and follow-up
Education that empowers you to understand your care
Whether working with an adolescent navigating academic pressures or an adult managing focus challenges and anxiety, my goal is to provide care that is steady, compassionate, and practical.
Expanding Access to Mental Health Care:
How Psychiatric/ Mental Health Nurse Practitioners (PMHNPs) Are Helping Meet a Growing Need
Access to timely mental health care has become increasingly difficult across the United States. As the demand for psychiatric services continues to rise, many communities are facing a shortage of psychiatrists, resulting in long wait times for appointments. For individuals struggling with conditions such as ADHD, anxiety, depression, bipolar disorder, or other mental health concerns, waiting weeks, or even months, for an evaluation can delay treatment and prolong unnecessary suffering.
Fortunately, Psychiatric-Mental Health Nurse Practitioners (PMHNPs) are helping bridge this gap by expanding access to high-quality psychiatric care.
Addressing the Psychiatrist Shortage
The United States is experiencing a well-documented shortage of psychiatrists. At the same time, awareness of mental health has grown, leading more people to seek evaluation and treatment than ever before. This imbalance between supply and demand means many psychiatrist practices have extended wait lists, making it difficult for patients to receive care when they need it most.
PMHNPs play an important role in helping address this shortage by providing comprehensive psychiatric services alongside psychiatrists and other mental health professionals.
PMHNPs Are Licensed Medical Providers
PMHNPs are licensed medical providers who have completed advanced graduate education and specialized training in psychiatry.
Before becoming a PMHNP, an individual must first become a registered nurse and gain foundational nursing education. They then complete a rigorous graduate program, earning either a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) degree with a specialization in psychiatric and mental health care. After graduation, PMHNPs must successfully pass a national board certification examination, obtain state licensure as an Advanced Practice Registered Nurse (APRN), and maintain continuing education throughout their careers.
PMHNP education includes advanced study in:
Advanced health assessment
Pathophysiology
Advanced pharmacology
Psychiatric diagnosis
Psychopharmacology
Evidence-based treatment of mental health conditions
Supervised clinical training in psychiatric care
PMHNPs are qualified to:
Perform comprehensive psychiatric evaluations.
Diagnose mental health conditions.
Order and interpret appropriate diagnostic testing when clinically indicated.
Develop individualized treatment plans.
Prescribe psychiatric medications in accordance with state law.
Monitor medication effectiveness and side effects.
Provide ongoing medication management and patient education.
PMHNPs routinely evaluate and treat conditions including ADHD, anxiety disorders, depression, bipolar disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), insomnia, and many other psychiatric conditions.
Receiving Psychiatric Care Sooner Can Make a Difference
One of the greatest benefits of seeing a PMHNP is improved access to care.
Because psychiatrist appointment availability is often limited, many patients experience long delays before their first visit. PMHNPs help reduce these wait times by increasing the number of qualified providers available to evaluate and treat patients.
Earlier access to care means:
Symptoms can be evaluated sooner.
Appropriate treatment can begin earlier.
Patients spend less time waiting while their symptoms interfere with work, school, family life, or daily functioning.
Follow-up care is often more readily available.
For many individuals, beginning treatment even a few weeks sooner can have a meaningful impact on quality of life.
Collaborative Care in Texas
Texas has regulations that support collaborative practice between PMHNPs and physicians.
While PMHNPs independently perform psychiatric assessments, diagnose conditions, develop treatment plans, and manage patient care, certain controlled substances require physician delegation and oversight under Texas law. This collaborative approach helps ensure patients receive timely access to treatment while maintaining appropriate physician involvement when required.
Rather than replacing psychiatrists, PMHNPs work as part of the broader mental health care team. Collaboration allows patients to benefit from both advanced nursing expertise and physician oversight where state regulations require it.
High-Quality, Patient-Centered Psychiatric Care
The goal of psychiatric treatment is not simply to prescribe medication. Effective mental health care begins with listening carefully, understanding each person's unique circumstances, performing a thorough evaluation, and developing an individualized treatment plan.
PMHNPs are trained to provide compassionate, evidence-based psychiatric care while building long-term therapeutic relationships with their patients. Whether treatment includes medication, psychotherapy referrals, lifestyle recommendations, or ongoing monitoring, the focus remains on helping patients achieve lasting improvements in their mental health.
The Bottom Line
The nationwide shortage of psychiatrists has made timely access to mental health care more challenging across the United States. Psychiatric-Mental Health Nurse Practitioners are helping expand access to safe, effective, and evidence-based psychiatric care by increasing the availability of qualified mental health providers.
PMHNPs are licensed medical providers with graduate-level education, specialized psychiatric training, national board certification, and state licensure. They are qualified to evaluate, diagnose, and treat a wide range of mental health conditions while practicing within state regulations and collaborating with physicians when required.
If you've never received care from a PMHNP before, it's understandable to have questions. Many patients are unfamiliar with the role of a Psychiatric-Mental Health Nurse Practitioner because the profession has grown significantly in response to the increasing demand for mental health services. Today, PMHNPs provide comprehensive psychiatric care in hospitals, community mental health centers, academic medical centers, Veterans Affairs facilities, and private practices throughout the United States.
At Keystone Adult & Adolescent Psychiatry, patients can also feel confident knowing that care is provided within a collaborative practice model. Our provider maintains an active collaborative relationship with a licensed, board-certified psychiatrist (MD) in accordance with Texas law. While your psychiatric evaluation, diagnosis, treatment planning, and ongoing medication management are provided by your PMHNP, physician collaboration and oversight are available when required, including for certain controlled substance prescribing as mandated by Texas regulations. This collaborative approach combines the accessibility of a PMHNP with the additional reassurance of physician involvement where appropriate.
Our commitment is simple: to provide compassionate, thorough, and evidence-based psychiatric care that places your well-being first. Whether your treatment includes medication, therapy recommendations, lifestyle interventions, or a combination of approaches, our goal is to ensure you feel heard, respected, and confident in the care you receive.
Our Philosophy of Care
At Keystone Adult & Adolescent Psychiatry, we believe every patient deserves timely access to compassionate, evidence-based mental health care. Whether your provider is a psychiatrist or a Psychiatric-Mental Health Nurse Practitioner, the most important aspect of treatment is receiving thoughtful, individualized care from a qualified clinician who takes the time to listen, understand your concerns, and develop a treatment plan tailored to your unique needs.
Our goal is never simply to prescribe medication. Instead, we strive to build lasting therapeutic relationships based on trust, open communication, and shared decision-making so that you feel informed, supported, and confident throughout your mental health journey.
If you are seeking online psychiatric care in Texas for ADHD, anxiety, depression, or other mental health concerns, Keystone Adult and Adolescent Psychiatry can help.
Get Started on Your Keystone Care, Today.
Frequently Asked Questions
For your convenience, we also have a more detailed Frequently Asked Questions (FAQ) page with answers to some common questions patients have.
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Yes. PMHNPs are licensed to prescribe psychiatric medications, including those used to treat conditions such as anxiety, depression, ADHD, and mood disorders.
Prescribing is always done thoughtfully, with careful monitoring to ensure safety and effectiveness.
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Yes. At Keystone Adult and Adolescent Psychiatry, we maintain an active collaborative relationship with a licensed, MD Psychiatrist.
This collaboration provides:
Ongoing clinical consultation
Additional oversight for complex cases
Support for best practices in psychiatric care
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Yes. Our Texas clinic has a licensed, board-certified psychiatric mental health nurse practitioner (PMHNP-BC), as well as a collaborating MD psychiatrist, who are able to prescribe medications if clinically appropriate, and monitor your progress through follow-up visits. We follow all federal and state regulations to ensure safe prescribing practices are followed.
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Yes. When clinically appropriate, our provider is able to prescribe controlled substances online used for psychiatric treatment as part of a structured and individualized treatment plan.
We follow all applicable prescribing laws, clinical guidelines, and safety protocols to ensure responsible care.
Medication is not guaranteed and is never prescribed automatically.
Treatment recommendations depend on:
Clinical evaluation findings
Symptom history
Medical history
Safety considerations
Diagnostic criteria