Medical Credentialing Medical Credentialing Documents for Therapists and Counselors Download NEW Enrollment Checklist Download Associated Enrollment Checklist Name * First Name Last Name Email * Board Approved Clinical Supervisor (Primary) * All Interns MUST Provider the following information for their Board Approved Clinical Supervisors/Primary Supervisors. If Fully licensed Type N/A. 1. First and Last Name 2. License Number 3. Phone number 4. Email CSW - Intern's Access Letter * CSW-Interns with External Supervisors will need a letter from Changing Minds Psychiatry's Chief Clinical Director authorizing access to the EHR system. This letter will need to be submitted to the Board of Examiners for Social Worker's to apply for a second site. Email "Celeste@changingmindspsych.com" I will request the letter. I have received the letter already. I am not a CSW-Intern Thank you!
