Organizational Providers Application

Thank you for your interest in joining Mid-State Health Network (MSHN). Please review the application checklist prior to starting your application as it cannot be saved once the application has been started. The checklist will identify documentation required to be uploaded with your application.

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 $1,000,000 per occurrence and $3,000,000 aggregate).

MSHN directly contracts with Substance Use Disorder (SUD) treatment, prevention, and recovery providers. If you are a provider of SUD services, please click ‘Next’ to complete the application. Upon completion, the MSHN Provider Network Department will contact you directly.

There are twelve Community Mental Health Service Participants (CMHSPs) in the MSHN region that contract directly with mental health providers. If you are a provider of mental health services, please select the CMHSPs for which you are applying. A list of CMHSPs and their catchment area may be found on the MSHN website. Upon completion, the CMHSP Provider Network Department will contact you directly.

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

Optional Providers

Thank you for your interest in joining the Provider Panel. Please select all organizations you wish to submit an application to and fill out the application below.