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Indiana Professional Licensing Agency

PLA > Professions > Behavioral Health and Human Services Licensing Board > How to Change/Update Your Name How to Change/Update Your Name

If you have a legal name change and wish to change the name on your license, you will need to submit official documentation to verify the change.  This documentation includes a marriage license/certificate, social security card, or divorce decree.  The request for name change must be made in writing (including the official documentation) to our office by faxing 317.233.4236, e-mail to pla5@pla.IN.gov, or by mailing 402 West Washington Street, Indianapolis, Indiana, 46204.  Your name change request must include your license number and how you want your name to read on your license. 

To receive an updated license with your changed name, please verify that the name change has been completed by our office at http://www.in.gov/pla/license.htm.  Once it has been updated, you may request a duplicate license to be issued to you at the same website.  There is a $10 fee to receive a new license.

If the name change is simply due to a typographical error made by the Board's office, please e-mail pla5@pla.IN.gov to notify us of the error.  You will need to include your license number and how your name should read on your license; a new license will be issued to you at no cost.