Provider Demographic Changes

Provider related data changes including but not limited to phone number & address updates can be completed easily using our Secure Provider Portal. Secure Web Portal

• Instructions on How to Manage your profile and Account (PDF).
• LTSS Addendum and FTE Reporting Form (PDF)

Provider Demographic and date updates can also be made by contacting Provider Services at 844-626-6813 or emailing us at PHWProviderData@PAHealthWellness.com.