All new and existing AODA and BEHAVIORAL HEALTH PRACTITIONERS providing services through the Wraparound Milwaukee Provider Network are required to comply with the credentialing requirements as indicated. Re-credentialing will occur every 3 years for active, current practitioners in the Network.
Completed Wraparound Milwaukee Universal Application are to be submitted upon request following the agency site visit.
EXISTING VENDORS – NEW PRACTITIONERS
WRAPAROUND MILWAUKEE CREDENTIALING INFORMATION AND FORMS
Credentialing applications must include:
- Original copy Universal Application (completed, signed and dated) form to Wraparound Milwaukee Provider Network
- Verification of practitioner’s education, training, licensing and/or certifications
- Completion of background check (all 3 parts)
- Confirmation of professional liability insurance
- Medicaid/Medicare sanctions search
Related Information/Forms Universal Application
Submit Completed Universal Application Form to:
Mail: Wraparound Milwaukee Provider Network
9455 Watertown Plank Road, Milwaukee, WI 53226
No individual will be excluded from participating in Wraparound Milwaukee’s credentialing process on the basis of gender, race, religion, age, disability, sexual orientation, ethnic origin or client population served.