Licensed Independent Practitioners Application

Thank you for your interest in joining Mid-State Health Network. Enclosed is an application for credentialing and privileges, along 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.
  • Board Certification (applies to physicians).
  • Insurance: Current malpractice insurance and professional liability insurance in the amount required by MSHN (minimum $3,000,000 per occurrence and $3,000,000 aggregate).

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 us at 517-253-7525.

For your convenience, please click here and download the checklist before continuing.

Please provide an email address where you will recieve an access code that can be use to reload the form and resume progress.