Create New Resource 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 2. 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 3. 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 4. Contact Information Organizational Contact for Nationwide Children's Hospital Community Resource Guide Inquiries and UpdatesFirst Name Last Name Title Email Address Phone Next 5. General Comments General Comments Next
