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Pamela Ruppel PMHNP-BC

Pamela Ruppel PMHNP is the owner of and psychiatric nurse practitioner at Star Behavioral Health and Roanoke TMS. She has over 22 years of experience as a nurse practitioner providing psychiatric care and mental health treatment to patients of all ages.

Pamela completed her Bachelor of Science in Nursing at Indiana University in 1987. She went on to earn her Master of Science in Nursing in 2001 at Rush University. She completed her Psychiatric NP degree at Indiana University. Pamela is certified by the American Nurses Credentialing Center as a Psychiatric Mental Health Nurse Practitioner (PMHNP).

In her work at Star Behavioral Health, Pamela conducts psychiatric assessments, diagnoses mental health disorders, and develops individualized treatment plans for each patient. She prescribes and manages medications when appropriate. Pamela also provides psychotherapy and counseling to help patients develop coping strategies and work through emotional issues.

Pamela has particular expertise in treating conditions such as treatment resistant depression, anxiety, PTSD, and bipolar disorder with interventional procedures. She takes a holistic approach to mental healthcare, looking at each patient's unique bio-psycho-social needs.

In addition to her clinical work, Pam is completing a fellowship at the Integrative Psychiatric Institute to become certified as a psychedelic practitioner. She regularly attends conferences and continuing education courses to stay up to date on the latest advances in psychiatric care. She is excited about the recent integration of group therapy into our practice.

Pamela is dedicated to reducing stigma around mental illness and improving access to behavioral health services in her community. She is passionate about helping patients achieve long-term mental and emotional wellbeing.

Randy Ruppel, MD

Dr. Randy Ruppel is the medical director of Roanoke TMS in Roanoke, Virginia. He received his medical degree from the University Michigan School of Medicine and completed his residency in pediatrics at Children’s National Medical Center and his Critical Care fellowship at the University of Pittsburgh.

Dr. Ruppel has experience in psychiatry and treating patients with depression, anxiety, and other mental health conditions. He has a special interest in using transcranial magnetic stimulation (TMS) as a non-invasive treatment for depression and other disorders.

As medical director of Roanoke TMS, Dr. Ruppel oversees the use of TMS therapy to help patients achieve remission from major depression, OCD, and smoking cessation. He works closely with patients to determine if they are candidates for TMS and closely monitors their progress throughout the TMS treatment regimen.

He also enjoys teaching medical students and psychiatry residents about the latest advances in treating mood disorders.

When he's not caring for patients, Dr. Ruppel enjoys spending time with his family, playing the piano, and hiking. He is dedicated to providing compassionate, evidence-based psychiatric care to help each of his patients thrive.


Stephanie Sylvester-Johnson PMHNP-BC

Stephanie Sylvester-Johnson, PMHNP-BC, is a dedicated and experienced psychiatric mental health nurse practitioner committed to providing comprehensive and compassionate mental health care. With a strong background in psychiatric nursing, Stephanie has developed a deep understanding of the complexities of various mental health conditions and the impact they can have on individuals and their families.

Stephanie earned her Associates of Science in Nursing from Jefferson College of Health Sciences, her Bachelor of Science in Psychology from Radford University, and went on to complete her Master of Science in Nursing (MSN) with a specialization in Psychiatric Mental Health Nurse Practitioner (PMHNP) at Frontier Nursing University. She is certified by the American Nurses Credentialing Center (ANCC) as a board- certified psychiatric mental health nurse practitioner (PMHNP-BC).

With a passion for evidence-based practice, Stephanie stays abreast of the latest developments in psychiatric care and incorporates the most current treatment modalities into her practice. She has a proven track record of providing individualized treatment plans for patients dealing with a wide range of mental health issues, including depression, anxiety, bipolar disorder, and schizophrenia.

Stephanie believes in fostering a collaborative and supportive relationship with her patients, working closely with them to develop personalized treatment goals and plans. Her empathetic and nonjudgmental approach creates a safe and nurturing environment for patients to discuss their concerns and work towards improved mental well-being.

Stephanie is currently welcoming new patients and looks forward to helping individuals achieve their optimal mental health and overall wellness.

Hillary Marshall - Practice Manager

Hillary Marshall is a seasoned healthcare professional and the Practice Manager at Star Behavioral Health, where she has made significant contributions over the past two years. Hillary plays an integral role in enhancing operational efficiency and elevating patient care standards within the practice. Her journey in healthcare began in dentistry in 2019. Hillary joined our practice in 2022. She established a solid foundation in medical billing and coding, earning a specialist certificate from Penn Foster in 2021. She is certified through the NHA as certified billing and coding specialist.


 Hillary is currently advancing her expertise by pursuing a Bachelor’s degree in Healthcare Administration from Western Governors University (WGU). This endeavor is a testament to her commitment to personal growth and her dedication to the healthcare sector. She is passionate about streamlining practice operations, improving patient experiences, and creating a nurturing environment for both staff and patients. Hillary’s leadership and dedication are pivotal to the ongoing success and reputation of Star Behavioral Health, making her an invaluable asset to the team and the broader healthcare community.

Darlene Niehaus – Psychiatric Nursing Assistant

Darlene is a highly valued member of the Star Behavioral Health team, serving with dedication as a Psychiatric Nursing Assistant since 2022. With over seven years of experience in the field, Darlene brings a wealth of knowledge and a compassionate approach to her role, deeply impacting the lives of those she cares for.


Darlene's exceptional personality shines through in her daily interactions, fostering a warm and supportive environment for patients and colleagues. Her commitment to high-quality care is evident in her meticulous attention to patients' needs, ensuring they receive the utmost support and empathy.

Ines Carter – TMS Technician

Ines joined our team in November 2021 as our TMS technician.  She has a bachelor’s degree from the University of Colorado in psychology and has worked in the mental health field for 20+ years. Ines lived in South America for several years and is fluent in Spanish. She hopes to be able to assist our Hispanic community in the pursuit of mental health.

Ines has a passion for discovering the needs of her patients, not only with their emotional struggles but also caring about their lives and relationships. Our patients have commented that "she cares about our lives and asks me real questions about my day and takes an interest in everything about me".  

Ines continually strives to keep current with the latest TMS research.  She has a special interest in autism research using TMS.

In her free time, Ines loves to travel, hike, and spend time with her family and friends.

Natalie Lilly –  Psychiatric Nursing Assistant

Natalie Lilly is a dedicated Psychiatric Nursing Assistant at Star Behavioral Health, having joined the team in 2023. With a solid background in human services counseling, Natalie brings a unique blend of empathy, understanding, and specialized knowledge to her role. Her passion for mental health care is the driving force behind her commitment to providing exceptional support to patients and their families.


Natalie's educational and professional journey in human services counseling has equipped her with a profound understanding of the complexities of mental health issues. This foundation allows her to approach her duties with a compassionate and informed perspective, making a significant difference in the lives of those she assists.


Jaime Norris – Revenue Cycle Assistant

Jaime Norris is the astute Revenue Cycle Assistant at Star Behavioral Health, a role she assumed in 2024. With a solid background in medical billing and coding, Jaime brings a crucial skill set to the practice, ensuring the smooth and efficient management of the billing cycle, from patient registration and insurance verification to billing and payment processing.


Her expertise in medical billing and coding is not just technical; it encompasses a deep understanding of the healthcare reimbursement process, compliance, and the importance of accuracy in patient billing. 


Before joining the team, Jaime honed her skills and knowledge in a variety of healthcare settings, developing a comprehensive approach to the revenue cycle management. Her professional background is marked by a commitment to excellence, continuous improvement, and a patient-centered approach to financial services.


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