Independent Clinical Supervisor - Initial Licensure

To obtain the Independent Clinical Supervisor certification:

• Applicants must hold one of the following licenses:

  • Clinical Substance Abuse Counselor (CSAC)

  • Licensed Clinical Social Worker (LCSW)

  • Marriage and Family Therapist (MFT)

  • Licensed Professional Counselor (LPC)

  • A temporary LCSW, MFT or LPC license

• Applicants can meet the education requirement in one of the following ways:

  • Complete 30 hours of education in clinical supervision, including a minimum of 6 hours in each of the following:

    • Assessment and evaluation.

    • Counselor development.

    • Management and administration.

    • Professional responsibility.

  • Hold an American Association for Marriage and Family Therapy supervisor certification.

• Applicants can meet the experience requirement in one of the following ways:

  • Complete 1 year of supervision as a Clinical Supervisor in-Training under an approved supervisor within the last 5 years. The supervisor(s) must submit form 2778 to confirm the experience. Please note that the required 1 year of experience may not be completed as an Intermediate Clinical Supervisor.

  • Hold one of the following licenses:

    • Licensed Clinical Social Worker (LCSW)

    • Marriage and Family Therapist (MFT)

    • Licensed Professional Counselor (LPC)

    • A temporary LCSW, MFT or LPC license

• Applicants must pass the National Certification Commission for Addiction Professionals (NCC AP) National Clinical Supervision Endorsement (NCSE) written exam prior to receiving a license. Instructions and authorization code will be provided upon initial review of a submitted application.
  
  

Below are some general instructions for applying for a credential on LicensE. 

1. Create or log into your LicensE account. Please visit LicensE account Information page for detailed guidance on selecting your account type.

2. Select "Apply for a License."

3. Select your Category.

4. Select your License Type.

5. Select your Application Method, then "Next."

6. Review your Personal Information.

7. Enter the requested Information on each page of the application. Information may include Examination, Education, or License History, depending on your profession.

8. If applicable, request a Veterans Fee Waiver or Initial Credential Fee Reduction.

9. Submit the requested Documents you may already have. You do not need to have all documents ready to submit.

   Note: Forms are now hosted on AccessGov. Visit AccessGov Forms Directory to choose your form.

10. Respond to the Attestation questions.

11. Provide Payment Information. Fees may be found Credential Fees.

12. Submit your application.  

Profession specific application requirements can be found in the "Application Information" section.

Create or log into your LicensE account

Select Apply for a License

Category: Health

License Type: Clinical Supervisor, Independent

Application Method: Initial

Add Supervisor:

To add a supervisor, type in their license number slowly including a space before and after the ‘-‘ and select the license number from the drop down. Then select Add Supervisor. Repeat the process for each of your supervisors. If you cannot find their license number in the drop down, you can check the box and manually enter their name and email address, then select add supervisor. Once you are done adding supervisors, click Next to continue.

If you are meeting the supervision requirement by holding one of the licenses listed above, you may skip this page.

Important: If you manually enter the supervisor’s name and email address, they will get an automated email indicating they are not approved to supervise with instructions on how to request approval to supervise.

To add a supervisor, type in their license number slowly including a space before and after the ‘-‘ and select the license number from the drop down. Then select Add Supervisor. Repeat the process for each of your supervisors. If you cannot find their license number in the drop down, you can check the box and manually enter their name and email address, then select add supervisor. Once you are done adding supervisors, click Next to continue.

If you are meeting the supervision requirement by holding one of the licenses listed above, you may skip this page.

Important: If you manually enter the supervisor’s name and email address, they will get an automated email indicating they are not approved to supervise with instructions on how to request approval to supervise.

Required:

• Form 2776 Clinical Supervisor Education and Training

  • Course descriptions for each course listed on form 2776

  • Proof of attendance and completion for each course listed on form 2776

• Form 2778 Affidavit Regarding Supervisory Experience for Intermediate or independent Clinical Supervisor (third party) (not required if you hold a full or temporary LCSW, MFT or LPC license)

• NCSE Written Exam (third party)

Required if Applicable:

• Supervisor Certification by the AAMFT (not required if submitting form 2776)

Supervision of the Clinical Supervisor In-Training license may be exercised by a Clinical Supervisor. A Clinical Supervisor means an individual who practices or has training in substance abuse clinical supervision; provides substance abuse counseling, treatment, or prevention services within the scope of their credential; and holds an unencumbered and active credential in good standing granted by the department or respective examining board as one of the following: ​​

Intermediate or Independent Clinical Supervisor

Licensed Clinical Social Worker (LCSW)

Marriage and Family Therapist (MFT)

Licensed Professional Counselor (LPC)

Psychologist (requires pre-approval)

Licensed Physician (requires pre-approval)

Applicants are required to pass the National Clinical Supervision Endorsement (NCSE) written exam to obtain the Independent Clinical Supervisor license. Please note that the department will provide instructions and an authorization code for taking the national exam upon initial review of the submitted Independent Clinical Supervisor application. For questions about the exam, please contact the National Certification Commission for Addiction Professionals (NCC AP) directly.

After you upload all required documents, submit your application, and pay the required fee(s):

1. Preliminary Application Reference Number (PAR)

   1. Your application will be assigned a Preliminary Application Reference number or PAR number. This number allows you and trusted parties to look up the status of your application without logging in. You can also reference this number in any support tickets you submit in regard to your application.

      • A trusted 3^rd party can look up your credential status by visiting LicensE, clicking “Application Status Lookup” and entering the PAR number you have provided to them.

2. Review Timeline

   1. Your materials will be reviewed within approximately 10 days by a member of the credentialing team.

      • Note: Some licenses do take longer to process due to complexity. You can see the performance data on our LicensE Dashboard to see what date we are reviewing for certain application types under "Application Review Times by Profession."

3. Pending Applicant Input Status

   1. After this review, if anything is missing or the credentialing team has any questions on your application, your application will go back into a status called “Pending Applicant Input.”  You will receive an email letting you know your application was moved into this status. You should then log into LicensE and check your application “Due Diligence.”

4. To check your "Due Diligence" 

   1. Your Due Diligence is a checklist of items required for your credential.

   2. The Due Diligence section is how DSPS staff will communicate with you regarding your credential requirements.

   3. Log in to your LicensE account

   4. Click on "Check Application Status" 

   5. Your credential application should be shown on this page. Under “Action” select the button that looks like an upside-down triangle. If you are on mobile, you will need to turn your phone into landscape view. Note: LicensE is best viewed on a desktop or laptop.

   6. After clicking the upside-down triangle, select “View Due Diligences.”

   7. The Due Diligence column lets you know what the requirement is.

   8. The “STATUS” column will you know if the item is “Met”, “Not Met”, or “Not Applicable.”

      • Items listed as “Not Met” are items that are needed by the Department.  

   9. The “NOTES” column of your Due Diligence will provide further written details or instructions about what is still needed.

5. To upload documents

   1. Some applications require additional document uploads.

   2. Log into your LicensE account

   3. Click on "Check Application Status"

   4. Your credential application should be shown on this page. Under "Action" select the button that looks like an upside-down triangle. If you are on mobile, you will need to turn your phone into landscape view. Note: LicensE is best viewed on a desktop or laptop. 

   5. After clicking the upside-down triangle, select "Upload Document."

   6. The document must be an allowable document type. 

   7. After uploading the document, click "submit." If you do not, it will not be sent to a reviewer. 

6. If you have any questions, you can submit a support ticket on LicensE by logging in and clicking "request support" at the top of the page.

LicensE statuses that require action from applicant:

LicensE statuses that indicate the application is with Department staff:

Support Ticket
Submit a support ticket on LicensE and click "request support." Please provide as much detail as possible regarding your concern so we can work to answer your question with a one touch resolution. 

Call
608-266-2112

Email
dsps@wisconsin.gov

Office Hours
7:45am-4:30pm
Department of Safety and Professional Services
4822 Madison Yards Way
Madison, WI, 53705

Note: The in-person office does not process same day.