1. Organization Information

Please use this form to submit a new or update an existing Behavioral Health Community ResourceName of Organization/Practice

Website Link

Organization Phone Number

Organization Fax Number

Organization Email Address

Short Description

Provider Description

Special Population

Next

  1. Primary Location/Headquarters

     	If you have more than four locations, please contact us at bhcommunityresources@nationwidechildrens.org to add additional locations.Street Address 1
    

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types Of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages served

0 - 6

7 - 12

13 - 17

18 and up

Next

2a. Additional Location 1

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2b. Additional Location 2

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2c. Additional Location 3

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2d. Additional Location 4

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

  1. Insurance Information

Accepted Insurance

Medicaid

Most Commercial and Private Insurance Plans

Limited Commercial and Private Insurance Plans

Sliding Scale Income based self-pay

Self-Pay

Link to Online Referral Form (if applicable)

Next

  1. Contact Information

Organizational Contact for Nationwide Children’s Hospital Community Resource Guide Inquiries and UpdatesFirst Name

Last Name

Title

Email Address

Phone

Next

  1. General Comments

General Comments

Next

  1. Organization Information

Please use this form to submit a new or update an existing Behavioral Health Community ResourceName of Organization/Practice

Website Link

Organization Phone Number

Organization Fax Number

Organization Email Address

Short Description

Provider Description

Special Population

Next

  1. Primary Location/Headquarters

     	If you have more than four locations, please contact us at bhcommunityresources@nationwidechildrens.org to add additional locations.Street Address 1
    

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types Of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages served

0 - 6

7 - 12

13 - 17

18 and up

Next

2a. Additional Location 1

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2b. Additional Location 2

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2c. Additional Location 3

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2d. Additional Location 4

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

  1. Insurance Information

Accepted Insurance

Medicaid

Most Commercial and Private Insurance Plans

Limited Commercial and Private Insurance Plans

Sliding Scale Income based self-pay

Self-Pay

Link to Online Referral Form (if applicable)

Next

  1. Contact Information

Organizational Contact for Nationwide Children’s Hospital Community Resource Guide Inquiries and UpdatesFirst Name

Last Name

Title

Email Address

Phone

Next

  1. General Comments

General Comments

Next

  1. Organization Information

Please use this form to submit a new or update an existing Behavioral Health Community ResourceName of Organization/Practice

Website Link

Organization Phone Number

Organization Fax Number

Organization Email Address

Short Description

Provider Description

Special Population

Next

  1. Primary Location/Headquarters

     	If you have more than four locations, please contact us at bhcommunityresources@nationwidechildrens.org to add additional locations.Street Address 1
    

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types Of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages served

0 - 6

7 - 12

13 - 17

18 and up

Next

2a. Additional Location 1

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2b. Additional Location 2

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2c. Additional Location 3

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2d. Additional Location 4

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

  1. Insurance Information

Accepted Insurance

Medicaid

Most Commercial and Private Insurance Plans

Limited Commercial and Private Insurance Plans

Sliding Scale Income based self-pay

Self-Pay

Link to Online Referral Form (if applicable)

Next

  1. Contact Information

Organizational Contact for Nationwide Children’s Hospital Community Resource Guide Inquiries and UpdatesFirst Name

Last Name

Title

Email Address

Phone

Next

  1. General Comments

General Comments

Next

  1. Organization Information

Please use this form to submit a new or update an existing Behavioral Health Community ResourceName of Organization/Practice

Website Link

Organization Phone Number

Organization Fax Number

Organization Email Address

Short Description

Provider Description

Special Population

Next

  1. Primary Location/Headquarters

     	If you have more than four locations, please contact us at bhcommunityresources@nationwidechildrens.org to add additional locations.Street Address 1
    

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types Of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages served

0 - 6

7 - 12

13 - 17

18 and up

Next

2a. Additional Location 1

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2b. Additional Location 2

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2c. Additional Location 3

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2d. Additional Location 4

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

  1. Insurance Information

Accepted Insurance

Medicaid

Most Commercial and Private Insurance Plans

Limited Commercial and Private Insurance Plans

Sliding Scale Income based self-pay

Self-Pay

Link to Online Referral Form (if applicable)

Next

  1. Contact Information

Organizational Contact for Nationwide Children’s Hospital Community Resource Guide Inquiries and UpdatesFirst Name

Last Name

Title

Email Address

Phone

Next

  1. General Comments

General Comments

Next

  1. Organization Information

Please use this form to submit a new or update an existing Behavioral Health Community ResourceName of Organization/Practice

Website Link

Organization Phone Number

Organization Fax Number

Organization Email Address

Short Description

Provider Description

Special Population

Next

  1. Primary Location/Headquarters

     	If you have more than four locations, please contact us at bhcommunityresources@nationwidechildrens.org to add additional locations.Street Address 1
    

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types Of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages served

0 - 6

7 - 12

13 - 17

18 and up

Next

2a. Additional Location 1

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2b. Additional Location 2

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2c. Additional Location 3

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

2d. Additional Location 4

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

  1. Insurance Information

Accepted Insurance

Medicaid

Most Commercial and Private Insurance Plans

Limited Commercial and Private Insurance Plans

Sliding Scale Income based self-pay

Self-Pay

Link to Online Referral Form (if applicable)

Next

  1. Contact Information

Organizational Contact for Nationwide Children’s Hospital Community Resource Guide Inquiries and UpdatesFirst Name

Last Name

Title

Email Address

Phone

Next

  1. General Comments

General Comments

Next

Please use this form to submit a new or update an existing Behavioral Health Community ResourceName of Organization/Practice

Website Link

Organization Phone Number

Organization Fax Number

Organization Email Address

Short Description

Provider Description

Special Population

Next

Please use this form to submit a new or update an existing Behavioral Health Community Resource

		If you have more than four locations, please contact us at bhcommunityresources@nationwidechildrens.org to add additional locations.Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types Of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages served

0 - 6

7 - 12

13 - 17

18 and up

Next

County

Show More Show Less

Treatment Areas at this Location

Types of Services at this Location

Ages served (Select All That Apply)

Location Name

Street Address 1

Street Address 2

City

State

Zip Code

County County

Adams

Allen

Ashland

Ashtabula

Athens

Auglaize

Belmont

Brown

Butler

Carroll

Champaign

Clark

Clermont

Clinton

Columbiana

Coshocton

Crawford

Cuyahoga

Darke

Defiance

Delaware

Erie

Fairfield

Fayette

Franklin

Fulton

Gallia

Geauga

Greene

Guernsey

Hamilton

Hancock

Hardin

Harrison

Henry

Highland

Hocking

Holmes

Huron

Jackson

Jefferson

Knox

Lake

Lawrence

Licking

Logan

Lorain

Lucas

Madison

Mahoning

Marion

Medina

Meigs

Mercer

Miami

Monroe

Montgomery

Morgan

Morrow

Muskingum

Noble

Ottawa

Paulding

Perry

Pickaway

Pike

Portage

Preble

Putnam

Richland

Ross

Sandusky

Scioto

Seneca

Shelby

Stark

Summit

Trumbull

Tuscarawas

Union

Van Wert

Vinton

Warren

Washington

Wayne

Williams

Wood

Wyandot

Show More Show Less

Phone

Fax

Treatment Areas at this Location Treatment Areas

Adjustment Problems

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Behavior and Conduct Problems

Eating Disorders

Gender or Sexuality (LGBTQ)

Grief and Loss

Intellectual Disabilities

Mood and Anxiety

Obsessive Compulsive Disorders (OCD)

Other Intellectual Disabilities

Problem Sexual Behaviors

Psychosis or Schizophrenia

School or Academic Problems

Substance Use

Suicide or Self-Harm

Trauma (PTSD)

Show More Show Less

Types of Services at this Location Types of Services

Adult Services

Case Management

Crisis Services

Day Treatment

Day Treatment/Partial

Early Childhood Mental Health (ECMH)

Foster care Services

Inpatient for Child 12 and Under

Inpatient for Child 13-17

Intensive Home and Community Based Services

Intensive Outpatient (IOP)

Office Based

Partial Hospitalization or Day Treatment

Primary Medical Care

Psychiatry

Psychological Testing

Residential Adolescents

Residential Children

Residential for Child 13-17

School Based

Telehealth

Transition Aged Youth Services (18-21)

Show More Show Less

Ages served (Select All That Apply) Ages Served

0 - 6

7 - 12

13 - 17

18 and up

Next

Accepted Insurance

Medicaid

Most Commercial and Private Insurance Plans

Limited Commercial and Private Insurance Plans

Sliding Scale Income based self-pay

Self-Pay

Link to Online Referral Form (if applicable)

Next

Organizational Contact for Nationwide Children’s Hospital Community Resource Guide Inquiries and UpdatesFirst Name

Last Name

Title

Email Address

Phone

Next

Organizational Contact for Nationwide Children’s Hospital Community Resource Guide Inquiries and Updates

General Comments

Next

  1. General Comments