Thank you for your interest in joining Community Mental Health for Central Michigan’s Provider Network. Enclosed is an application for credentialing, service request, and with related attachments.
The following qualifications must be demonstrated in your application materials in order for us to accept your application:
- License: A current unrestricted, unconditional license to practice mental health and/or substance use disorder services in the State of Michigan.
- Certification (if applicable): Current certifications to provide specialized services as required by the State of Michigan.
- Accreditation (treatment programs only): Current accreditation from a national body approved by the State of Michigan.
- Insurance: Current malpractice insurance and professional liability insurance in the amount required by MSHN (minimum $1,000,000 per occurrence and $3,000,000 aggregate).
- Enrollment in CHAMPS system.
The application and attachments may be filled out electronically; however, you must print, date, and sign the application and required attachments. The application and attachments must be dated within 30 days of receipt by the Provider Credentialing Specialist.
If you have any questions related to the criteria identified above, or questions about completing the application and/or attachments, please feel free to contact me at 989-772-5938.
For your convenience, a checklist has been included on page 6 of the application.
Tonya Lawrence, MBA
Provider Network Manager
CMH for Central Michigan