An Orthodox Jewish man called an out-of-town psychologist to inquire about beginning therapy. Shortly after the client identified his presenting concern, the psychologist asked him basic demographic information, such as his name. The prospective client responded that he was uncomfortable sharing his name, both now over the phone and even later if he became a client. The psychologist was somewhat struck by this comment and tried to reassure the prospective client by explaining the strict terms of confidentiality. The prospective client replied that he comes from an Orthodox Jewish community where the stigma of coming to therapy was extremely high and that he did not want to risk the possibility that others could discover that he attended therapy. Consequently, he did not want even his own therapist to know his name. Later in the phone call, the prospective client stated that he needed to use his health insurance to pay for therapy services. The psychologist explained that he would not be able to submit claims to the insurance company without knowing the client’s name. The client understood and politely said that he then would not be able to attend therapy.