Request Services

If you would like to get services with us, please click this link to fill out our Request for Services Form: REQUEST FOR SERVICES  

The above link is to request Therapy, Substance Use Treatment, and/or Medication Management/Prescribing services.

Payment Options/Insurances Accepted: 

• DEAN Commercial insurance (payer IDs: 41822 and 39113) 

• DEAN Forward Health 

• Straight Medicaid with no HMO attached 

• Medicare

• Self Pay

Click this link to fill out our Request for Services Form: REQUEST FOR SERVICES