North Dakota Medicaid Provider Enrollment Attestation - Licensed Baccalaureate Social Worker - North Dakota

North Dakota Medicaid Provider Enrollment Attestation - Licensed Baccalaureate Social Worker - North Dakota

North Dakota Medicaid Provider Enrollment Attestation - Licensed Baccalaureate Social Worker is a legal document that was released by the North Dakota Department of Health and Human Services - a government authority operating within North Dakota.

FAQ

Q: What is the North Dakota Medicaid Provider Enrollment Attestation?
A: It is a form that licensed Baccalaureate Social Workers need to complete.

Q: Who needs to complete the North Dakota Medicaid Provider Enrollment Attestation?
A: Licensed Baccalaureate Social Workers in North Dakota.

Q: What is the purpose of the North Dakota Medicaid Provider Enrollment Attestation?
A: To enroll Baccalaureate Social Workers as Medicaid providers in North Dakota.

Q: Is the North Dakota Medicaid Provider Enrollment Attestation specific to licensed Baccalaureate Social Workers?
A: Yes, it is specifically for licensed Baccalaureate Social Workers in North Dakota.

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Form Details:

  • Released on September 6, 2019;
  • The latest edition currently provided by the North Dakota Department of Health and Human Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the North Dakota Department of Health and Human Services.

Download North Dakota Medicaid Provider Enrollment Attestation - Licensed Baccalaureate Social Worker - North Dakota

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