Forms, Appointments, Insurances
If you have an urgent need PLEASE dial 911 or contact NETCARE at 614-276-2273 for 24-hour mental health emergencies.
Click on the following links to access and print documents:
Client Intake Forms < click link
Client Financial Responsibility Statement Form < click link
Note: for your security and privacy, the completed intake form will not save to your computer - please print.
There are two options to submit a completed Client Intake form:
Print and fax form to: 614-337-2936 Call: 614-337-1986
Print and mail form to:
Lighthouse Christian Services, Inc.
2085 Mecca Road
P.O. Box 248447
Columbus, OH. 43224
Clients paying for services through any one of the following insurance companies may have the option of receiving EITHER in network OR out-of-network benefits, depending upon their policies. Practice Management Solutions 614-771-1778Call: 614-771-1778) provides us with billing services.
COUNSELOR AND INSURANCE PROVIDERS ACCEPTED
|Anthem Blue Cross Blue Shield*|
|CARESource (Medicaid and/or Medicare benefits)|
|Cigna Behavioral Health|
|Impact EAP (OSU)|
Medical Mutual/Supermed Plus
|PHCS (Private Healthcare System) Affiliated Companies|
|OSU Prime Care Advantaage/NGS American|
|United Behavioral Health (same as United Health Care)/|
|United Behavioral Health (Same as United Health Care) Optum EAP *|
|Military Onesource EAP *|
|Value Options EAP*|
|Workplace Options EAP*|
Yamina Henderson (MA, PC)
Counseling locations: Mecca Road (central Columbus); Potter's House (Westside). Mon/Tues/Weds/Thurs.
Medical Mutual insurance provider.
|*CALL TO OBTAIN AUTHORIZATION NUMBER. When you call, you will need provide the following:|
|The Name of Your Counselor at Lighthouse Counseling Services, 2085 Mecca Rd., Columbus, OH 43224.|
|**FYI: JP Morgan Chase EAP is administered by Workplace Options (same as MHN).|
|Once Chase EAP sessions expire, client must see a counselor who is in or out-of-network for UBH or Cigna.|
|Clients paying for services through any one of the preceding insurance companies may have the option|
|of receiving EITHER in-network OR out-of-network benefits, depending upon their policies.|
|Practice Management Solutions (614-771-1778) provides us with billing services.|