m a t r i x p s y c h . c o m

Re-Credentialing Form:
Download this form if you are a current Matrix National Network provider who needs to complete the recredentialing process.

Provider Application:
If you are interested in becoming part of the Matrix National Network, download our provider application.

Please return completed applications and recredentialing forms to us either via fax or mail:

Attn: Network
Matrix
2 Easton Oval, Ste. 450
Columbus, OH 43219
Fax: 614/475-9821