Therapist Credentialing & License Verification Form

Streamline Therapist Credentialing with Paperform

For mental health practices, group therapy centers, and behavioral health organizations, credentialing new therapists is a critical but time-consuming process. This Therapist Credentialing & License Verification Form template helps you collect all the essential information you need—from state licensure and liability insurance to theoretical orientation and specialty populations—in one professional, organized form.

Why mental health practices choose this template

This template is purpose-built for HR managers, clinical directors, and practice administrators who need to:

• Verify professional credentials including state licenses, certifications, and educational background
• Document liability insurance with policy numbers and coverage amounts
• Understand clinical approach through theoretical orientation and treatment modalities
• Match therapists with clients based on specialty populations and areas of expertise
• Track supervision requirements for pre-licensed clinicians and associates
• Maintain compliance with state regulations and insurance panel requirements

Automate your credentialing workflow

Once a therapist submits their credentials, you can use Stepper (stepper.io) to automate your entire verification process. Set up workflows that notify your clinical director for review, trigger background checks, send documents to Papersign (papersign.com) for electronic signatures on employment agreements, and update your HR database—all without manual data entry.

With conditional logic built in, the form automatically adapts based on license type, asking for supervision documentation when needed and capturing the right specialty certifications for your practice area.

Designed for mental health professionals

This template includes fields for multiple license types (LMFT, LCSW, LPC, psychologist, psychiatrist), NPI numbers, DEA registration for prescribers, malpractice insurance verification, and detailed clinical background information. Whether you're a small private practice or a larger behavioral health organization, this form creates a consistent, professional credentialing experience that protects your practice and ensures quality care.

Paperform is SOC 2 Type II compliant and designed with data security in mind, giving you peace of mind when collecting sensitive professional information. Start with this template and customize it to match your specific state requirements, insurance panel needs, or organizational policies.