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The University of the State of New York THE STATE EDUCATION DEPARTMENT Office of the Professions Division of Professional Licensing Services www.op.nysed.gov Licensed Psychologist Attestation of Supervision

How to fill out licensed psychologist attestation of

How to fill out licensed psychologist attestation of:

1. Start by entering your personal information in the designated fields. This may include your name, contact information, and professional credentials.
2. Provide details about your current licensure, such as the issuing authority, license number, and expiration date.
3. Indicate whether you have any pending or previous disciplinary actions taken against your professional license. If yes, provide the necessary details.
4. Describe your current employment situation, including the name of the organization or practice you are affiliated with, your position, and the dates of your employment.
5. If you have worked at multiple locations within the past five years, provide the names and addresses of all the places you have practiced.
6. Attach any additional documentation required, such as copies of your current license, continuing education certificates, or any relevant publications.
7. Review all the information provided to ensure accuracy and completeness. Make any necessary corrections before submitting the attestation form.

Who needs licensed psychologist attestation of:

Licensed psychologist attestation may be required by individuals in various professional settings. Some common instances where a licensed psychologist attestation may be necessary include:

1. Applying for a job as a psychologist: Potential employers may require you to submit an attestation form to verify your qualifications and licensure.
2. Credentialing process: Insurance companies and healthcare organizations often require licensed psychologists to provide attestation forms as part of the credentialing process.
3. Professional organizations: Membership in certain professional organizations may require you to submit an attestation form to validate your credentials.
4. Applying for research grants or funding: Some grant applications or funding opportunities in the field of psychology may require a licensed psychologist attestation.

In conclusion, filling out a licensed psychologist attestation of involves providing accurate personal and professional information, describing current and previous employment situations, and attaching any required supporting documents. This form may be required for various purposes such as job applications, credentialing processes, or membership in professional organizations.

For pdfFiller’s FAQs

What is licensed psychologist attestation of?

Licensed psychologist attestation is a formal declaration or confirmation of certain information by a licensed psychologist.

Who is required to file licensed psychologist attestation of?

Licensed psychologists are required to file licensed psychologist attestation.

How to fill out licensed psychologist attestation of?

Licensed psychologists must fill out the attestation form with accurate information and sign it to certify its accuracy.

What is the purpose of licensed psychologist attestation of?

The purpose of licensed psychologist attestation is to ensure that licensed psychologists are in compliance with certain regulations and standards.

What information must be reported on licensed psychologist attestation of?

Licensed psychologists must report information such as their license number, contact information, and any relevant qualifications or certifications.

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