License Status Questions

License Questions

You need to be able to say "No" to all of the following questions (Answering Yes to anything below will put a stop to moving forward. It does not mean we cannot move forward, Counseling Professionals may need more information to ensure your eligibility to practice as a therapist with Counseling Professionals or how we need to consider your application. To appeal, email Samantha Quiel (Onboarding Director) here): SamanthaQuiel@CounselingProfessionalsPLLC.com

• Has your license to practice in any jurisdiction ever been limited, restricted, reduced, suspended, voluntarily surrendered, revoked, denied or not renewed; have you ever been reprimanded by a state licensing agency; or are any of these actions pending with respect to your license; are you under investigation by any licensing or regulatory agency?

• Has your professional employment or membership in a professional organization ever been subject to disciplinary proceedings, denied, limited, restricted, reduced, suspended, revoked, not renewed, or voluntarily relinquished during or under threat of termination for any reason?

• Has your Drug Enforcement Agency registration or other controlled substance authorization ever been limited, restricted, reduced, suspended, revoked, denied, not renewed, or have you voluntarily surrendered or limited your registration during or under threat of investigation or are any such actions pending?

• Have you ever been sanctioned or suspended by Medicare or Medicaid?

• To your knowledge, have you ever been reported to the National Practitioner Data Bank or the North/South Carolina Board of Medical Examiners?

• Have you ever been convicted of a felony or misdemeanor, or are you under investigation with respect to such conduct?

• Has a professional liability claim been assessed against you in the past five years, or are there any professional liability cases pending against you?

• Has any liability insurance carrier canceled, refused coverage, or rated up because of unusual risk or have any procedures been excluded from your coverage?

• Have you ever practiced without liability coverage?

• Do you currently have any medical, chemical dependency or psychiatric conditions that might adversely affect your ability to practice medicine or surgery or to perform the essential function of your position?

• Have your Hospital and/or Clinic privileges ever been limited, restricted, reduced, suspended, revoked, denied, not renewed, or have you voluntarily surrendered or limited your privileges during or under the threat of an investigation or are any such actions pending?