The top part of this kind must be finished by the applicant and despatched to the right state licensing board for their submission towards the Indiana Professional Licensing Agency. The form may very well be duplicated should you keep several licenses.
Title Alter Documentation: Documentation of any lawful name adjust In the event your name differs from that on any of the files.
The non permanent allow will probably be issued Once the applicant has satisfy all licensure specifications to be authorised for his or her countrywide Test.
Assessment Acceptance: After all documentation continues to be reviewed and accepted, an applicant who may have not taken the countrywide Examination will get an Examination approval from our Place of work. An applicant who has long been authorised with the Board to take the assessment must go ahead and take examination inside of one (one) calendar year within the date on the initial Board approval. When the applicant hasn't taken the assessment within just a single (one) calendar year within the date of Preliminary Board acceptance, the acceptance might be invalid plus the applicant must submit a whole new software and all necessary documentation must be resubmitted.
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The highest percentage of this kind need to be accomplished by the applicant and sent to the appropriate condition licensing board for his or her submission for the Indiana Specialist Licensing Company. The form may very well be duplicated when you hold many licenses.
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A different point out-regulated addiction counseling Qualified or, When the practical experience was attained in the condition where no regulation exists, by an addictions or behavioral health Specialist of equivalent status;
Verification of Licensure (if applicable): If you keep a license or certification in another Condition, you must deliver verification of that information and facts. Verifications must be done with the point out of issuance and might be uploaded in your on the web account.
If you can't discover the answer to your question then e-mail is the principal type of communication utilized by the Division and licensing boards.
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Type C- Verification of Coursework: Applicants for an habit counselor license need to have PROENC a baccalaureate in addiction counseling or in a linked region as determined by the board from an suitable postsecondary educational institution that satisfies the necessities from the board.
Form C- Verification of Graduate Coursework: Applicants for your scientific addiction counselor license will need to have a graduate in dependancy counseling, dependancy therapy, or in the related place as based on the board from an eligible postsecondary academic establishment that meets the requirements in the board.