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Performing Provider's License Data Section

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Enter performing provider license information. License Type (e.g. LCSW, MD, PhD, MFCC, etc.) the state of the license (e.g. New York, California, Minnesota, etc.) as well as verification information is also tracked here.

  1. Go to: Avatar MSO > Provider Management > Performing Provider Registration.
  2. In the Performing Provider License Data table, click Add.
  3. In the License Type field, select the license type.
  4. In the License State field, select the state.
  5. In the License # field, enter the provider's license number.
  6. In the License Expiration Date field, enter the license expiration date.
  7. In the License Data Verified field, select Yes if the provider's license data is verified.
  8. In the License Data Verified By field, enter where the license was verified.
  9. In the License Data Verification Source field, enter the verification source.
  10. In the Date License Data Verified field, enter the license verified date.