AODA / Behavioral Health Credentialing

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.

NEW VENDORS

Completed Wraparound Milwaukee Universal Application are to be submitted upon request following the agency site visit.

EXISTING VENDORS – NEW PRACTITIONERS

Completed Wraparound Milwaukee Universal Application are to be submitted along with the Add Request Form (PDF), to include documentation outlined on the form.


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

Tips for Completing Credentialing Process     Credentialing/Recredentialing Criteria

Primary Source Verification     Credentialing/Recredentialing Plan

PROVIDER SPECIALTIY INFORMATION FORM

Submit Completed Universal Application Form to:

Mail: Wraparound Milwaukee Provider Network
9455 Watertown Plank Road, Milwaukee, WI 53226
Email: dana.james@milwaukeecountywi.gov
Fax: 414-257-7575

Questions about the status of a practitioner’s application should be directed to Theresa Randall or Dana James of Wraparound Milwaukee.

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.