Apply as an Individual Provider

Apply to become part of the LifeSynch provider team, either as a solo provider or a provider participating in a group.

Please note: If you are practicing in a group (same tax ID number), your group must submit an application or have one on file.

Two Ways to Apply

Select from one of the options for applying below.

The fastest way for physicians and other healthcare providers to securely submit their credentialing information.

Please note: Indiana, Rhode Island, Vermont, and Washington, D.C. providers are required by state law to apply via CAQH.

Download and complete state application forms.

Contact Provider Services at 1-800-890-8288 between 8 a.m. and 5 p.m., Central Time, Monday-Friday.

Quality service and patient safety are the driving force behind everything we do.