Provisional Licensees who change employers, DHHR county offices, titles, and/or licensing supervisors must file a Change for Provisional License Form with the Board.
To file a Change Report for Provisional License:
Download, complete, and return the form listed below.
Change Report for Provisional License Form (PDF)
Completed applications must be mailed to the Board office:
WV Board of Social Work
PO Box 5459
Charleston, WV 25361
Fax #: 304-400-4976