Psychotherapy - Individual or Group

You must have one of the following licenses to provide this service:

  • Licensed Clinical Psychologist
  • Licensed Clinical Social Worker
  • Licensed Marriage or Family Therapist
  • Licensed Clinical Professional Counselor

How Do I Become A Provider?

  1. Obtain a National Provider Identifier from the National Plan and Provider Enumeration System. 
    1. The NPI must be a Type 1- Individual.
    2. The taxonomy code must align with your license and the services that will be provided.
  2. Send a copy of your current license to:  DHS.DDDMedProv@illinois.gov .
  3. Submit an IMPACT provider enrollment application to enroll as a Developmental Disabilities Medicaid Waiver Provider.
    1. Create an IMPACT account on the IMPACT login page.  Please use the Single Sign-On ID PowerPoint Presentation found on the IMPACT Presentations and Materials page on the HFS website to complete this step. 
    2. When the Single Sign-On ID has been approved, return to the IMPACT login page and log into your account. There will be a blue IMPACT hyperlink located on the IMPACT home page under the 4 green boxes.  Click on the IMPACT hyperlink to access the IMPACT Provider Enrollment System. 
    3. Click on NEW ENROLLMENT.  On the next screen, select the Enrollment Type: 
      • Individual/Sole Proprietor
      • Regular Individual/Sole Proprietor or Rendering/Servicing Provider
    4. On the Basic information page, select the Applicant Type based on the definitions of Independent Sole Proprietor or Rending/Servicing Provider listed below Click on the applicant type links for further instructions.
      • Independent Sole Proprietor - A person that works independently and renders direct services to persons enrolled in the Developmental Disability Medicaid Waiver program.  Note:  This does NOT include persons that are the sole member of a LLC or owns and operates an incorporate business.
      • Rendering/Servicing Provider - A person that renders services in the Developmental Disability Medicaid Waiver program as an employee or contracted provider for company or provider group
  4. Send an email to DHS.DDDMedProv@illinois.gov to notify DHS, Division of Developmental Disabilities that your application has been submitted for state review. 

Important Resources for Program Requirements