Provider Screening, Enrollment & Credentialing

1. Send an email to credentialing@sfdph.org from your agency email account. 
2. For the subject line, use “requesting Credentialing-Mental Health/Epic” 
3. For the body of the email, include the following:
   1. Your name as it appears on your license, certification, etc. 
   2. Your NPI number and the taxonomy code and label
   3. The type of application you need:
      1. Application for Physician (MD/DO)
      2. Application for SUD Medical Director
      3. Application for Alcohol or Other Drug (AOD) Counselor (both Registered and/or fully Certified)
      4. Application for Social Work, Marriage Family Therapist, Professional Clinical Counselor (both BBS-Registered and/or fully Licensed) 
      5. Application for Psychologist (including Registered, Waivered and/or fully Licensed) 
      6. Application for Nurse Practitioner
      7. Application for Registered Nurse, Vocational Nurse, Psychiatric Technician, and/or Pharmacist
      8. Application for Unlicensed Staff Who Are MHW, MHRS and/or Clinical Trainee
4. Send the email and then monitor your email inbox (and spam folder) for an email from noreply@sfdph.org.
   1. Open the email and follow the instructions - - you will be taken to the online credentialing system and you will complete the application process.
   2. Approximately 5-7 business days after you submit the application, you will receive an email from BHS Compliance with the outcome of the credentialing process. 
5. As soon as you send the email to request credentialing - - you can move to the next phase and visit DPH Onboarding Webpage” to:
   1. Request a POI Number: individuals who do not have a DSW number will request a “Person of Interest” (POI) number that will be used to create your Epic EHR account. Remember that County-employed staff have DSW numbers and use this to obtain their account.
   2. Submit an Onboarding Request: you will be scheduled into a training session for the Epic EHR.

1. Fully complete the BHS IT Department’s Avatar Account Request form; the form must be typewritten and include required signatures. If you need assistance completing the form, contact the Avatar Help Desk at 628-217-5196.
2. Draft an email to avataraccounts@sfdph.org
3. For the subject line, use “Requesting SUD Credentialing and Avatar Account”
4. Send the email, with the completed form attached, and then monitor your email inbox (and spam folder) for an email from noreply@sfdph.org
   1. Open the email and follow the instructions - - you will be taken to the online credentialing system and you will complete the application process.
   2. Approximately 5-7 business days after you submit the application, you will receive an email from BHS Compliance with the outcome of the credentialing process. 
5. In a separate email, the BHS team will communicate with you about the Avatar ID Account number assigned to you.

1. Enter your name, NPI number and your email address into our Webform
2. Monitor your email inbox (and spam folder) for an email from noreply@sfdph.org
3. Open the email and follow the instructions - - you will be taken to the online credentialing system and you will complete the application process.
   1. Within 60 calendar days of submitting the application, you will receive an email from a staff member in the PPN with the outcome of the credentialing process. In addition, the PPN office will also send this information via postal mail.

When an individual provider leaves an agency, they and the agency must communicate this information within 5 business days to BHS Credentialing (e.g., a staff member resigns from the agency to take a different job). 

1. Fully complete the BHS Compliance Separation Notification Form 
2. Email the completed form to both  credentialing@sfdph.org and avataraccounts@sfdph.org