This is required of ALL providers that conduct HIPAA protected services, Regardless of your education level -- bachelor's, master's, or licensed - you need it.  So make sure your staff get one!  
You will update your NPPES profile as you go (taxonomy changes, address changes, etc).  All group practices that are operating under your group name and an EIN will also need a Type 2 Organizational NPI - this matches your EIN registered name.   (Same login/profile as the business owner: will have both the group/organizational NPI and the individual NPI.  Then each individual will have their own login for their own individual NPI - this follow them throughout their career).  

** IMPORTANT NOTE *** You are NOT   "Sam Smith LPC"    you are just Sam Smith.  Please do not add any credentials after your name, this is JUST to be your name.   Medicaid and Medicare are VERY picky and will reject everything if the names don't match (all profiles, make sure its all just your name). 

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We recommend everyone make one of these profiles but it is only required for the insurance path.  When you are creating your account - be sure to list your Practice name with a physical address even if it is a telehealth-only location. Most insurances wont accept "Virtual only" they need an address. Even if it is your home address, they do need an address. They need to know where YOUR BUTT is parked :) 

Please list your EIN and organizational/group NPI under your practice location. 

YOU ARE THE CONTACT - not someone else :)  We see so often that someone else is listed and then the provider never gets important correspondence. So make sure that YOUR name, email, phone etc is listed!  If you list someone else, THEY will get the emails and it creates major issues - so dont do it!  Just list yourself!!   (also, remember when you leave a practice, go edit your profile to remove all of their information) 

Enter your schooling information, your references, any judgments, work history, etc. This is the "master list" that insurances reference. So make sure its thorough and accurate! 

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We need the PDF application > on the home page BOTTOM RIGHT > click on the download my application NOT the summary (left).   Then send me that PDF  :)  Thank you Thank you!

This is just the reference guide. For MOST private practice owners you are NOT a clinic, center, agency or facility - you are usually a single or multi specialty - or whatever matches your license type :)  

Some examples: 

193400000X-Single Specialty Group

193200000X-Multi-Specialty Group

Mental Health Counselor -  101YM0800X

Professional Counselor  - 101YP2500X

Marriage and Family Therapists - 106H00000X

Clinical Social Workers  -  1041C0700X

Physician Assistant  -  ​363A00000X

We use this look up license information - but this is YOUR licensing regulatory agency! 

Important to note > make sure your name here is the same name you are using everywhere.  Inconsistencies throw red flags and errors with insurances during the credentialing & review process.

Diagnosis Resource Tool.  This is where most insurances and EHR's pull their list from. This is your starting point.  You can look up a diagnosis here and it will show "no longer valid"  or a red box "not billable"   and "need further specification"  so please use this :) 

If you are NOT medical provider, then you cannot use a medical diagnosis.   Autism is allowed for under 21, unless your a qualified to treat autism.  Otherwise, you are treating the symptoms - so use that diagnosis (anxiety, depression, adjustment, ptsd, etc)