Initial Provider Application - Virginia Department of Behavioral ... - dbhds virginia 2026

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  1. Click ‘Get Form’ to open the Initial Provider Application in our editor.
  2. Begin by filling out the 'Applicant Information' section. Enter your organization name, mailing address, city, county, state, zip code, phone number, and email. Ensure all details are accurate for a smooth application process.
  3. Next, identify the organizational structure by checking the appropriate boxes for non-profit or for-profit status and the type of entity (individual, corporation, etc.). This helps clarify your business model.
  4. In the 'Service Type' section, select the service you intend to provide by checking one box. If your service is not listed, specify it in the 'Licensed As Statement' area.
  5. Complete the 'Service Information' section with details about your service director and client demographics. This information is crucial for licensing approval.
  6. Finally, review all sections for completeness and accuracy before submitting. Use our platform's features to save your progress and make edits as needed.

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*QIDP (Qualified Intellectual Disorder Professional) designation requires one year's experience working with people with a developmental disability AND a bachelor's degree or higher in a human services field (including, but not limited to: sociology, special education, rehabilitation counseling or psychology).
The Virginia Department of Social Services licenses two levels of care in assisted living facilities (ALFs): residential living care (minimal assistance) or assisted living care (at least moderate assistance). Facilities licensed to provide assisted living care may also provide residential care.

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39 CSBs and the BHA in Virginia provide programs and services that. Insure the growth and development of infants who are or at risk of development disabilities, birth to age three, as well as supporting their families.
The Virginia Department of Social Services licenses two levels of care in assisted living facilities (ALFs): residential living care (minimal assistance) or assisted living care (at least moderate assistance). Facilities licensed to provide assisted living care may also provide residential care.
39 CSBs and the BHA in Virginia provide programs and services that. Insure the growth and development of infants who are or at risk of development disabilities, birth to age three, as well as supporting their families.
The QDDP / QIDP must possess at least one year of documented experience working directly with individuals who have intellectual disability or other developmental disabilities and one of the following credentials: a doctor of medicine or osteopathy licensed in Virginia, a registered nurse licensed in Virginia, or ( ...

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