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MARYLAND BOARD OF PROFESSIONAL COUNSELORS AND THERAPISTS 4201 PATTERSON AVENUE 316 BALTIMORE MARYLAND 21215 410-764-4732 www. dhmh. state. md. us/bopc/ INSTRUCTIONS ALCOHOL AND OTHER DRUG COUNSELING OUT OF STATE APPLICANTS LCADC Licensed Clinical Alcohol and Drug Counselor 1 Application Submit a completed Out-of-State Board application identifying the level of certification or licensure that you are requesting enclosed 2 Fee Submit 75. 00 NON RE...
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What is marylanddhmh professional form?
Marylanddhmh professional form is a form used by healthcare professionals in the state of Maryland to report their professional information.
Who is required to file marylanddhmh professional form?
All healthcare professionals practicing in Maryland are required to file marylanddhmh professional form.
How to fill out marylanddhmh professional form?
To fill out marylanddhmh professional form, healthcare professionals need to provide their personal information, professional qualifications, and any other required details as specified in the form.
What is the purpose of marylanddhmh professional form?
The purpose of marylanddhmh professional form is to ensure the state has accurate and up-to-date information about healthcare professionals practicing within its jurisdiction.
What information must be reported on marylanddhmh professional form?
The information required to be reported on marylanddhmh professional form includes personal details (name, address, contact information), professional qualifications (educational background, certifications, licenses), and any other relevant information as specified in the form.
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