December 22, 2021 – Commissioner’s order: Out of state licensed providers should read this memo from DPH Commissioner Manisha Juthani, MD and note the list of professions authorized by the Commissioner’s order

Reinstatement of Lapsed Certification

Before applying for licensure, please familiarize yourself with the general licensing policies.

 

An applicant for reinstatement of a Connecticut license that has lapsed due to non-renewal shall arrange for the submission of the following documentation directly to this office from the source:

 

The applicant’s current curriculum vitae (CV) or synopsis of professional activity since completion of the applicant's training;

 

Verification of any out-of-state licenses held, current or expired, submitted directly to this office from the source.  Please contact the jurisdiction prior to submission of the request as some may charge a fee for this service;

 

Verification from the appropriate authority confirming the applicant's most recent experience as a behavior analyst including dates and overall evaluation of the applicant's ability to practice with reasonable skill and safety.  If the applicant is in private practice, a letter from another practitioner with whom the applicant has referred patients will suffice.  The letter must indicate dates of the referral relationship and an evaluation of the applicant's ability to practice with reasonable skill and safety.

 

Typically, applicants for reinstatement who have not been in active practice for longer than five years are required to complete a period of refresher training.  Applicants to whom this applies will receive further information from the Department upon receipt of all required documentation.

 

Applications are only accepted online.  The application fee is $100.  If you do not recall your login information you may use the 'Forgot Password' or 'Forgot User ID' options when applying.

 

All supporting documentation should be forwarded from the source to:

 

Connecticut Department of Public Health

Community Health Worker Certification

410 Capitol Ave., MS #12 APP

P.O. Box 340308

Hartford, CT 06134

Fax:  (860) 707-1980

Email:  dph.counselorsteam@ct.gov