Provider Enrollment Guide
Follow this step-by-step guide to begin the process of enrolling as an Indiana First Steps Provider.
Determine your Early Intervention (EI) Role
- Entry level qualification for each EI role can be found in the Indiana First Steps Early Intervention Personnel Guide.
- You will also need to determine whether you will need to enroll as an independent provider, a provider with a multi-disciplinary agency or with a SPOE.
- Questions regarding entry level qualifications can be sent to FirstStepsWeb@fssa.in.gov.
Determine your Service Area
- First view a map of the Clusters and Service Areas throughout the state.
- If enrolling as an independent provider, you will need to decide which Service Area(s) to provide services in.
- If enrolling with a multi-disciplinary agency, you can find contact information for the agencies providing services in each of the Service Areas.
- If enrolling as a service coordinator, you can find contact information for the SPOE office in each Cluster.
Contact a multi-disciplinary agency or SPOE office (independent providers skip to next step)
- Providers (unless otherwise stated in the Personnel Guide) need to be employed by or contracted with an already established multi-disciplinary agency before continuing with enrollment.
- Service Coordinators need to be employed by a SPOE before continuing with enrollment.
Complete Provider Enrollment Checklist
- Independent Providers
- Multi-disciplinary Agency Providers
- Service Coordinators
- DME/Assistive Technology or Interpreter
- Facility Transportation
- Family Member Transportation
- Additional Forms which are listed on each checklist
Submit Checklist and Supporting Documentation for Enrollment
- Documents with ORIGINAL SIGNATURES must be mailed to Provider Enrollment for initial enrollment.
- Questions regarding forms or enrollment can be direct to Provider Enrollment at 1-866-339-9595 Option 2 and/or email (firstname.lastname@example.org).