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  • NMCC-WACC Staff Annual Update

    Dear team member, please complete this form to help expedite the annual update and attestion process.

  • Staff Information

  • BACKGROUND CHECK

  • Washington Area Clinical Center and the Maryland Department Health (MDH) are concerned about the health and safety of all individuals and the safeguarding of agency property.  All reasonable efforts will be made to provide a safe and secure environment for our patients, other team members, and their family members. Based on this objective, a criminal history record check. Please attest to the following information:

     

     

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  • CAQH

  • The CAQH is a document hub that insurance companies use to maintain updated information on providers. You must update and reattest to your CAQH for the duration of your participation with insurance companies. 

    Please create a CAQH HERE. Only answer the required questions (!!)

    Please make sure the following are added to your CAQH. 


    Washington Area Clinical Center

    2905 Mitchellville Road Suite 204

    Bowie, MD 20716-3961

    301-701-6965

    info@waccenter.com

    NPI: 1609485010

    Tax ID: 814548356

    and

     

    New Millennial Counseling & Consulting

    7225 Hanover Parkway Suite C

    Greenbelt, MD 20770

    240-459-3074

    info@newmillennial.org 

    NPI:1245774116

    Tax ID: 814548356

     

    You must sign AND attest for your CAQH to be complete. You must also enter your settings and ensure your profile is accessible to any organization who requests it (only insurance carriers have access). 

  • Professional Liability Insurance

    Staff are required to maintain a minimum coverage of 1M/5M aggregate for the duration of their term with the organization. Please submit proof of coverage.
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  • License Changes and Updates

    Please submit a Screenshot or PDF copy of your Professional License IF YOUR LICENSE HAS CHANGED since you have joined the team. For example, if you were an LG and are now an LC, please upload your LC license. Also, if you were only licensed in one state, but are now licensed in two states, please upload the additional state license. If you are joining or a part of the Medical Team, please upload CURRENT copies of your CDS and DEA credentials.
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  • Health Information

  • COVID- 19 Vaccine

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  • Baseline Individual TB Risk Assessment

    Please answer the questions below. Your answers to the questions will determine whether you are required to receive additional TB testing, per CDC guidelines. If you are required to receive additional testing, NMCC-WACC reimbuse your for the cost of testing.
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  • Website Photo and Bio

    Please answer the following questions thoughtfully as they will be used to construct your profile on the website.
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  • Attestation

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