Insurance Credentialing Services Checklist
for Mental Health Practices
Price Application
Per Provider
$150
Initial Information Gathering
• Collect personal information: full name, date of birth, Social Security number, and contact details.
• Obtain government-issued identification: driver’s license or passport. Gather proof of citizenship or legal residency: birth certificate, passport, or permanent resident card.
• Collect National Provider Identifier (NPI): both individual (Type 1) and organizational (Type 2) as applicable.
• Obtain Tax Identification Number (TIN) or Employer Identification Number (EIN).
• Gather malpractice insurance details: policy number, coverage limits, and provider information.
Work History and Experience
• Prepare a current Curriculum Vitae (CV) or resume.
• Obtain employment verification letters: from current and previous employers.
• Collect contact information for professional references: including supervisors and colleagues.
Educational and Professional Documentation
• Collect academic transcripts and diplomas: from undergraduate and graduate institutions.
• Obtain proof of supervised clinical training: including practicum and internship details.
• Gather state licensure information: including license number, issue date, and expiration date.
• Collect board certification details: including certification body and certification number.
• Obtain continuing education records: certificates of completed courses or workshops.