Application Status Query

Instructions: 

Please allow one hour after receipt of your status update email for the updates to be reflected in the online checklist.

Please verify the checklist information below, including your address. If your address has changed, please e-mail your application number, name, profession, along with your old and new address. The Credentialing department posts status information following receipt and review of application materials.

As of  :  09/03/2024
Application#  :  790200
Name  :  Derenne Hansen, Ashley M
Profession  :  Licensed Professional Counselor
Address  :  Manitowoc, WI
Application Status  :  (Permanent license issued)


Requirements Not Met:
Description Status Comments (Please note, not all requirements will include comments)

Requirements Met:
Description Status Comments (Please note, not all requirements will include comments)
Application Complete Met
9/3/2024 Applicant applied in LE on 7/12/2024, app IA-405344. - DB
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01/14/22 Your application has been reviewed. This item will remain unmet until all other requirements are met. - jnl
Application Fee Met
3/6/23: Temp renewal fee in LicensE 3/4/23 TL-077409 $10 - ENI
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7/19/22: Rec'd - ENI
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01/14/22 No payment information included with application. Need $75 for initial credential fee and $60 national exam contract fee (including 3 retakes) for a total of $135. You can also add the optional, non-refundable $10 temporary fee. To pay by credit card, complete and return Fax Payment Form #3071 (https://dsps.wi.gov/Credentialing/General/fm3071.pdf) or send a check made out to DSPS to "Attn: LPC, DSPS, PO Box 8935, Madison, WI 53708-8935. - jnl $145
Supervised Professional Counseling Experience Form(s) Met
7/19/22: Rec'd 3272 total hours and 3043 face to face hours under Todd Eiden from 8/14/17-8/3/21 -ENI
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01/14/22: Rec’d Form #2464 with 3,272 total hours with 3,043.25 hours of face-to-face client contact under Todd Eiden indicating you began accruing hours on 07/20/17 to 8/3/2021; however, your PCTL (LPC-IT) was NOT issued until 08/14/17. Any hours obtained PRIOR to your PCTL (LPC-IT) issued on 7/20/17 cannot be counted; Please have your supervisor redo Form #2464 (https://dsps.wi.gov/Credentialing/Health/fm2464.pdf) and return to DSPSCredJointBd@wi.gov - jnl
Certification of Professional Education Met
01/14/22: Met with PCTL - jnl
Temporary License Requested Met
7/19/22: Rec'd - ENI
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01/14/22: Need $10 fee; to grant temporary ALL requirements must be complete EXCEPT the score from NBCC or CRC - jnl
NCHMHE, NCE or CRCE Exam Met
08/29/24: NOTE: Exam results received. PASS - LJM
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5/23/2024 NOTE: Exam results received. Retake needed. NEED: $15.00 x 3 = $45 retake Exam Fee; use payment form #3071 and email to dspsrenewal@wisconsin.gov or mail to: Attn: LPC, DSPS, PO Box 8935, Madison WI 53708-8935 – DB
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08/01/23: retake required, need $15.00 x 2 = $30 retake Exam Fee; use payment form #3071 and email to dspsrenewal@wisconsin.gov or mail to: Attn: LPC, DSPS, PO Box 8935, Madison WI 53708-8935 – LJM



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visit NBCC website for more information regarding the national exam (NCE or NCMHCE) or visit CRC website for more information regarding the national exam (CRCE) - LJM

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11/23/22: retake required need $15.00 Contract Exam Fee, send Fax Payment Form 3071 to (608)251-3036, or mail payment to: Attn: LPC, DSPS, PO Box 8935, Madison WI 53708-8935

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scores rec’d, retake required; visit NBCC website for more information regarding the national exam (NCE or NCMHCE) or visit CRC website for more information regarding the national exam (CRCE) - LJM
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7/19/22: Rec'd retake fees - ENI
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4/26/22: Retake required need $15.00 Contract Exam Fee, mail to: Attn: LPC, DSPS, PO Box 8935, Madison WI 53708-8935 - ENI
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01/14/22: Results rec’d for 2/3/21, 7/21/21, 11/3/21 exams. Retake needed. visit NBCC website for more information regarding the national exam (NCE or NCMHCE) or visit CRC website for more information regarding the national exam (CRCE) – jnl