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About UsWho We Are
ServicesWhat We Do
ResourcesSuccessful Living Tips
Prayer MinistryBecome A Lightkeeper
Contact us

Online Therapist Signup Form

Lighthouse Network > Services > Case Management > About the Partner Network > Online Therapist Signup Form

Organization
Name
First Last
Address
Street Address Address Line 2 City Your State ZIP / Postal Code Country
Phone
Email
Website
Organization's Religious Orientation
Services you offer
Service Area Information
- Mental Health
- Counseling
- Partial Hospital
- Inpatient
- Intensive Outpatient
- Therapeutic Residential
- Outpatient
- Residential
- Medication Management
- Other Level of Care
If checked Other Level of Care above, please list here:
Mental Health Disorders Service
- Mood
- Anxiety
- Stress
- Relationship/Marital
- Abuse
- Impulse
- Attention/Focus
- Food/Body
- Memory
- Addictions
- Sleep
- Sexual
- Psychoses
- Pregnancy/PMS/Menopause
- Anger
- Other Disorder
If checked Other Disorder above, please list here:
Addictions - Type of Addiction Treatment Options Offered
- Interventions
- Detox
- Medical Rehab
- Non-Medical Rehab
- Partial Hospital Prog
- Intensive Outpatient
- Outpatient
- Halfway House
If other addiction treatment options offered, please list here:
Life Services - Type of Life Skills offered
- Financial
- Career Counseling
- Ministry Retreat
- Social Services
- Church Based Support Group
- Community Support Group
- Other Services Offered
If other Life Services offered, please list here:
Clients you service
Gender
- Male
- Female
Ages
- 0-10 yrs
- 11-19 yrs
- 20-35 yrs
- 36-55 yrs
- 56+ yrs
Language
- English
- Spanish
- French
- Korean
- German
- Chinese
If support for other language, please list here:
Structure
- Individuals
- Group
- Families
- Couples
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Email
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Contents[Show]

About

Lighthouse Network History
Mission and Vision
Doctrinal Statement
Our Board and Staff
Core Spiritual Beliefs
Core Principles and Values
Testimonials

Resources

Addictions
Mental Health
Life Growth Materials
Life Growth Videos
Recommended Lists
Social Policy
Assessment Tools
Treatment of Schizophrenia Without Medication

Services

Addiction & Mental Health Helpline
- Drug and Alcohol Abuse Counseling Helpline
- Learn About Our Addiction Therapy and Counseling Helpline
Case Management
- Online Clinical Assessment Form
Treatment Program Consulting
Curriculum / Workshop Development
Social Issue Task Forces

Contact

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Guest Speaker
Lighthouse Press and Media
- Press Kit
- Radio
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- Print

Inpatient Treatment

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treatment options, call us now!

CALL (844) 543-3242

Get help now! Call (844) 543-3242