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Indiana First Steps Annual Credential Form

Indiana First Steps Annual Credential Form 2025

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The document is an Annual Credential Form for Indiana First Steps, outlining the requirements and necessary documentation for service providers to maintain their credentials. It includes a checklist of items needed, such as a signed attestation statement, criminal history check, National Provider Identifier (NPI), and proof of training. The form also addresses personnel information, prior convictions, and supervision agreements for specific roles within the program.

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Versions	Form popularity	Fillable & printable
2021	4.2 Satisfied (34 Votes)
2018	4.1 Satisfied (58 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How to become a developmental therapist in Indiana?

To become a developmental therapist, earn a bachelors degree in early childhood education, developmental psychology, social work, or a related field. Once you obtain your degree, complete a childhood education and early intervention internship to gain experience as a child therapist.

How to become an unlicensed child care provider in Indiana?

To become a CCDF certified unlicensed provider: Child care providers must meet the CCDF provider eligibility standards. Submit your application online at I-LEAD via Open a New Program on the Dashboard. Pass onsite inspection from the Legally licensed exempt provider consultant.

How to become a first step provider in Indiana?

Audiologists, interpreters, psychologists, registered dieticians and social workers who are interested in becoming an independent contractor must contact the Indiana Early Intervention Hub Provider Enrollment Management team directly at ineihubenroll@pcgus.com for more information on becoming a provider.

How to become a Medicaid transportation provider in Indiana?

To become a provider of Medicaid transportation, interested applicants must: Apply through the Indiana Health Coverage Programs (IHCP) by filling out an enrollment packet. Pay the application fee. This fee will vary depending on the risk level assigned by the Centers for Medicare Medicaid Services.

How to become a choice provider in Indiana?

CHOICE Provider Application Process All agencies interested in providing services for CICOA and our clients must be certified through the Medicaid Waiver program. All providers (including non-medical agencies) must also be licensed through the Indiana State Department of Health. ! Attend CHOICE Information Session.

What age is first steps in Indiana?

First Steps is Indianas early intervention program that provides services to infants and toddlers from birth to third birthday who have developmental delays or disabilities.

Who is eligible for first steps in Indiana?

A diagnosed physical or mental condition that has a high probability of resulting in a developmental delay: Chromosomal abnormalities. Genetic or congenital disorders. Sensory impairments. Inborn errors of metabolism. Disorders reflecting disturbance of the development of the nervous system. Congenital infections.

How is Indiana First Steps funded?

First Steps is funded through existing services, local, state, and federal funding, Medicaid, and private insurance. For more information about the Indiana First Steps through DSI Services, contact us below.

Indiana First Steps Annual Credential Form 2025

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