Aetna application request behavioral health

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Contact Aetna – Health Care Professionals | Aetna

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Member login. Member register. Behavioral Health Provider Application Request. Behavioral Health Please complete this form if you are interested in joining Aetna's network. Information about application and credentialing process As a practitioner, you have the right to correct any information obtained during the credentialing process by working directly with the reporting entities.

Phone ext.

Middle initial. Primary Care Physician. Are you applying to join an existing group that participates with Aetna? Hospital affiliation 1. Hospital affiliation 2. Hospital affiliation 3. Hospital affiliation 4. Hospital affiliation 5. Previous Next. Select an option the same different. NPI contact first and last name. NPI contact's phone number 10 digits. Entity type. Does this NPI apply to all service locations and billing addresses for this provider only?

Populations you work with Children ages: Adolescents ages: Adults ages: Seniors ages: Handicap accessible Yes. American sign language Yes. Please check up to 8 areas of focus. Addiction Psychiatry. Addiction Specialist. Adolescent Psychiatry. Anxiety Disorders.

Attention Deficit Disorder. Bereavement-Grief Counseling. Certified Employee Assistance Professional.