Re-credentialing packets

Applications for Licensed Independent Practitioners (LIP) who need to re-apply to the CMHPSM Panel (every 2 years).

Please choose the appropriate recredentialing packet for your profession. You must also submit a DHS and RFP Application form.

• Re-Credentialing Application for Doctors and Nurses
• Re-Credentialing Application for Non-Licensed Professional (Speech & Language, Recreational, Music, Art and Massage Therapy)
• Re-Credentialing Application for Licensed Professional (Psychology, Social Work, Counseling, OT, PT, Nutrition)
  
  
• DHS Form (Must be included)      ** Please read the instruction on the last page of the packet!!