Humana actively recruits psychiatrists, nurse practitioners certified in behavioral health or psychiatry, psychologists, social workers, licensed professional counselors, licensed marriage and family therapists and behavioral health professionals who are licensed independently in the state where they practice. We are also seeking individuals holding a Certified Employee Assistance Professional (CEAP) certification in conjunction with the required state license.

If you are starting a new group agreement, you no longer need to apply for each individual provider in a group. After submitting this form, you will be contacted for a roster.

Provider interest form

Required fields
Provider agreement type Start new solo agreement Start new group agreement Join existing group agreement
Provider Name This field does not match the required pattern. Contact name This field does not match the required pattern.
Group Name (if applicable)
Existing provider CAQH (if applicable)
Existing provider CAQH (if applicable)
Contact Email This field does not match the required pattern.
Medicare ID Group NPI (if starting new group agreement)
State Select Alaska Alabama Arkansas Arizona California Colorado Connecticut Washington DC Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming County
Are you an ABA specialized provider/group? Yes No
Are you a Suboxone/Methadone specialized provider/group? Yes No


If you are applying as a solo provider, please select up to five specialties. Otherwise, choose "general practitioner". So that we can make proper referrals, only select specialties that represent at least 20% of your practice.
General practitioner Anger management Anxiety/phobic disorders Attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) Autism Brief psychotherapy Child abuse/neglect Chronic illness Community resource services Critical incident debriefing Disease management Stress management Eating disorders Family therapy Gay/lesbian issues Grief/death/dying Learning disabilities Marital therapy Mood disorders/depression Neuropsychological testing Change this Text Personality disorders Play therapy Postpartum issues Psychiatric disability Psychological testing Religious emphasis Sexuality Violence/trauma (rape/all abuse) please select up to five specialties.

To add one or more providers to an existing group agreement, please send a completed roster in Microsoft Excel format to