CPA for Therapists and Private Practices
Accounting, tax, and financial planning for mental health practices.
Shetland Financial works with therapists, counselors, and psychologists across the Lehigh Valley and Bucks County, from solo practitioners to group practices with a handful of clinicians. We are a fee-only CPA firm and registered investment advisor, so your practice books, your tax return, and your own retirement savings are handled by one coordinated team. You work directly with Kevin Dodgson, CPA, CFA, CFP®.
Most therapists we meet did not go into practice to run a business. They went into practice to see clients. Then somewhere between the first insurance panel and the first hire, the bookkeeping got away from them. That is the problem we solve.
Should your practice be an S corporation? This is the single biggest tax question in private practice, and the answer is not always yes. An S election can reduce self-employment tax once your profit is high enough to support a reasonable salary, but it adds payroll filings, a separate return, and real administrative cost. Below a certain profit level it costs more than it saves. We run the numbers on your actual practice rather than applying a rule of thumb, and if the answer is not yet, we tell you when to revisit it.
Insurance panels and cash pay do not reconcile themselves. If you take insurance, the amount you bill, the amount allowed, the amount the payer sends, and the amount the client owes are four different numbers. Practices that treat deposits as revenue end up with books that overstate income and a tax bill built on the wrong figure. We set up your bookkeeping so contractual adjustments, patient responsibility, and clawbacks are recorded properly, whether you bill through SimplePractice, TherapyNotes, or something else.
Retirement saving is where private practice actually wins. A solo practitioner with no employees has access to retirement vehicles that most employees never get, and the contribution room is substantial. Because we manage investments as well as prepare the return, we can size the contribution to the tax outcome you want and then actually invest it, rather than handing you a number in April and wishing you luck.
The everyday deductions people get wrong. Telehealth from a home office, continuing education and licensure renewal, professional liability insurance, supervision hours, clinical consultation, and the portion of your phone and internet that is genuinely business use. All legitimate, all routinely either missed or overclaimed. We would rather you take everything you are entitled to and nothing you are not.
We also handle the Pennsylvania side that out-of-state software tends to miss, including local Earned Income Tax filings and the Local Services Tax, which vary by municipality across Lehigh, Northampton, and Bucks counties.
And when the practice is doing well. Therapists who reach a good level of profit usually find the constraint shifts from earning to keeping. At that point the questions are about retirement plan contributions, what to hold where, and how to invest the money the practice throws off. Our wealth management page covers how we handle that side, and we are a fee-only fiduciary, so there is nothing being sold to you alongside the advice.
What you get
One team for the practice and for you. Practice bookkeeping, payroll, the business return, and your personal financial plan, coordinated rather than handed between three firms.
An honest answer on the S election. We model it against your actual numbers and tell you if it is not worth it yet.
Fee-only, flat-fee, no commissions. You know the price up front, and nobody here earns a commission on what we recommend.