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:
Overview of Client Services < click link
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 email form to: firstname.lastname@example.org
Print and mail form to:
Lighthouse Counseling Services, Inc.
5000 Sunbury Rd.
Columbus, OH 43230
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.
COUNSELOR AND INSURANCE PROVIDERS ACCEPTED
|Anthem Blue Cross Blue Shield|
|Cigna Behavioral Health|
|Impact EAP* (OSU)|
|Medical Mutual/Supermed Plus|
|Military Onesource EAP*|
|PHCS (Private Healthcare System) Affiliated Companies|
|Optima (formerly United Behavioral Health [UBH])|
|OSU Prime Care Advantaage/NGS American|
|Value Options EAP*|
|Workplace Options EAP*|
Yamina Henderson (MA, PC)
Telehealth Counseling Only. Insurance provider for Medical Mutual, Aetna, Aetna EAP*
|*TO UTILIZE YOUR EMPLOYEE ASSISTANCE PROGRAM (EAP), reference the counselor's name, location, and maintain a copy of the authorization number.|
|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.|