Skip to Main Content Area
Practitioner Requirements
Practitioner Requirements
Return to: Join Our Network Required Documents
Type of Practitioner Contract and Credentialing required Completed Application Malpractice Insurance W-9
Credentialed
Acupuncturist [LAC] Yes Yes Yes Yes
Audiologist [AuD] Yes Yes Yes Yes
Certified Diabetic Educator (Independent*) [CDE] Yes Yes Yes Yes
Clinical Psychologist [PhD; PsyD] Yes Yes Yes Yes
Doctor of Chiropractic [DC] Yes Yes Yes Yes
Doctor of Optometry [OD] Yes Yes Yes Yes
Doctor of Podiatry [DPM] Yes Yes Yes Yes
Enterostomal Therapy Yes Yes Yes Yes
Licensed Behavioral Analyst [ABA] Yes Yes Yes Yes
Licensed Clinical Social Worker [LCSW] Yes Yes Yes Yes
Licensed Marriage & Family Therapist [LMFT] Yes Yes Yes Yes
Licensed Mental Health Counselor [LMHC] Yes Yes Yes Yes
Medical Doctor [MD] Yes Yes Yes Yes
Midwife - Home Birth [CNM] Yes Yes Yes Yes
Midwife [CNM] Yes Yes Yes Yes
Nurse Practitioner, Primary Care Yes Yes Yes Yes
Nurse Practitioner, Psychiatry Yes Yes Yes Yes
Occupational Therapist [OT] Yes Yes Yes Yes
Oral Maxillofacial Surgery (DMD) Yes Yes Yes Yes
Osteopathic Doctor [DO] Yes Yes Yes Yes
Physical Therapist [PT] Yes Yes Yes Yes
Registered Dietician (Independent*) [RD] Yes Yes Yes Yes
Speech Pathologist [SLP] Yes Yes Yes Yes
Non-Credentialed Anesthesiologist No Yes Yes Yes
Certified Behavior Analyst Assistant No Yes Yes Yes
Certified Diabetic Educator [CDE] No Yes Yes Yes
Certified Registered Nurse Anesthetists [CRNA] No Yes Yes Yes
Emergency Room [MD] No Yes Yes Yes
Hospitalist [MD] No Yes Yes Yes
Locum Tenens [MD] No Yes Yes Yes
Nurse Practitioner [NP] No Yes Yes Yes
Pathologist [MD] No Yes Yes Yes
Physician Assistant [PA] No Yes Yes Yes
Registered Dietician [RD] No Yes Yes Yes
Registered Nurse First Assistant No Yes Yes Yes

* Independent - not employed by a hospital or facility