Mental Health/Substance Abuse
Please click on the links below if you wish to apply to become a provider, are renewing a provider certification, requesting to add a new service levels or to update demographics to an existing certification.
Timeline for completion of the online application process:
Please note: Online applicants, for both new and current providers, have 90 days to finalize the online application process; after that timeline expires the system will purge the application. If purging occurs, there is no way to access this information and any applicant with purged information must begin the application process over.
When submitting an application request to become a new provider, you will need to create a user ID and provide a valid email address. you will receive a 'no reply' email with a PIN number. The provider ID and PIN will be used if the application cannot be completed in one sitting. It is only good for that application submission and will no longer be valid once the application has been submitted for review.
WARNING! ONCE THE APPLICATION HAS BEEN SUBMITTED FOR REVIEW, THE USER ID AND PIN WILL NO LONGER BE VALID. RE-USING THE USER ID AND PIN WILL NOT SUBMIT ANY NEW OR UPDATED INFORMATION TO THE DIVISION, EVEN THOUGH IT MAY LOOK LIKE IT WAS SUBMITTED.
To submit a recertification application or to change any existing demographic information, click on the link at the bottom of the page
Click Here to Submit an Application a New Provider Application
The guidance documents are found below. New and existing applicants should print the guidance document first to assist them in preparing for the online application process. The guidance document informs applicants what information is necessary and helps to better understand the documentation and certification requirements.
Substance Abuse Treatment Certification Application Guidance (PDF)
Substance Abuse Treatment Certification Application Guidance (word)
Renewal application for state certified providers are electronically submitted through the electronic application portal link above. Please note that the renewal is on an annual basis and must adhere to approved requirements. Additional documents will assist in the process. Each non funded, non accredited provider submit a program evaluation which is an internal quality assurance process that documents all clinical records are complete, signed off, have measureable goals, objective and treatment plans follow and adhere to the goals, etc.
NOTE: The system will send an automated renewal application notice to each provider at least thirty (30) days prior to the current expiration date.
Once your new provider application has been reviewed and accepted you will receive a provider verification number (PVN). you will use this PVN to submit a recertification application, request to add a new level of service or to update. If you were not provided with a PVN (providers certified prior to 7/10/2015 will not have received a PVN), cannot locate your PVN, or need to change your PVN, please contact the BHD and they can update and/or provide you with the current PVN number.
NOTE: IF YOU ARE ADDING A NEW LOCATION, NOT UPDATING CURRENT ADDRESS INFORMATION, YOU MUST TREAT THE NEW LOCATION LIKE A NEW PROVIDER APPLICATION. ADDING A NEW LOCATION AS IF YOU ARE CHANGING THE EXISTING ADDRESS WILL CAUSE ERRORS IN THE SYSTEM.
To submit a new provider application , click on the link at the top of the page
Click Here to Submit Renewal Certification
FYI - Changes to your location, phone, email or staff OR to request a change of services between renewals CANNOT be done through the online system. Doing so may interfere with your ability to complete a renewal application in the future. Please contact the BHD at the phone number below or send an email to the address below.
Please contact the Behavioral Health Division at 1-800-535-4006 or via email at Portia.firstname.lastname@example.org for information.