State Alphabet Soup
Understanding Therapist Licensure: What Credentials Mean in Each State and How the Counseling Compact Is Changing the Game
Whether you're seeking therapy or considering becoming a licensed therapist, understanding mental health credentials and licensing across the U.S. can feel overwhelming. Each state has its own licensing board, title, and requirements—and when it comes to practicing across state lines, things get even more complex.
This post breaks down the different mental health therapy credentials by state, what it takes to get licensed, the legalities of offering services outside your home state, and what the Counseling Compact means for the future of therapy.
What Are the Common Mental Health Licenses in the U.S.?
Although requirements vary by state, here are the most common credentials for mental health therapists:
LPC – Licensed Professional Counselor
LMHC – Licensed Mental Health Counselor
LCPC – Licensed Clinical Professional Counselor
LPC-MH – Licensed Professional Counselor – Mental Health
LPC-S – Licensed Professional Counselor – Supervisor
LCSW – Licensed Clinical Social Worker
LMFT – Licensed Marriage and Family Therapist
LP or Psychologist – Licensed Psychologist (requires a doctoral degree)
These licenses allow professionals to provide therapy to individuals, couples, and families depending on their scope of practice and state laws.
What It Takes to Become a Licensed Therapist (State by State Overview)
Each state has its own licensure board and requirements, but most require:
A Master’s degree in counseling, social work, psychology, or a related field
2,000–4,000 hours of supervised clinical experience
Passing a national or state-specific licensing exam (e.g., NCE, NCMHCE, ASWB)
An application, fees, and background check
For a full list of requirements by state, consult the National Board for Certified Counselors (NBCC) or your specific state licensing board.
Other great resources for information are professional organizations such as the American Mental Health Counselor Association (AMHCA) and its state chapters.
Can Therapists Provide Services Across State Lines?
Generally, no—unless they are licensed in both states. Telehealth laws require that the client must be located in a state where the therapist is licensed.
For example:
If a therapist is licensed in New York, they cannot legally provide services to a client in Texas unless they also hold a Texas license.
Some states have temporary or emergency licensure options, but these are often limited or require special permission.
Offering therapy without a license in the client’s state can lead to fines, disciplinary action, or license suspension.
Enter the Counseling Compact: A New Path Forward
The Counseling Compact is a groundbreaking initiative that makes it easier for licensed professional counselors to practice across state lines.
Key Facts:
The compact allows eligible LPCs and equivalent licensees to practice in any other member state without obtaining a separate license.
It includes in-person and telehealth services.
Therapists must hold an active, unencumbered license in a Compact member state to participate.
As of June 2025:
34 states have passed legislation to join the Counseling Compact.
19 states are fully active and issuing privileges to practice.
States like Texas, Florida, Ohio, and Georgia are Compact members, making cross-state work much more accessible.
You can find up-to-date information on Compact implementation at counselingcompact.org.
What Does This Mean for Clients?
If you:
Travel between states frequently
Have relocated but want to stay with your current therapist
Live in a rural area with limited access to care
…the Counseling Compact opens the door for greater continuity in mental health care.
What Does This Mean for Therapists?
Therapists licensed in a Compact state can:
Legally provide teletherapy across multiple states
Expand their client base and specialty services
Avoid duplicate application processes and fees for multiple licenses
Note: Therapists must still comply with each state’s scope of practice and reporting requirements.
Final Thoughts: Navigating Licensure and Expanding Access
As mental health becomes a national priority, the ability to serve clients across state lines is crucial. The Counseling Compact is a giant leap forward, but it’s still important for both therapists and clients to understand the limits of licensure and ethical boundaries.
Whether you're a clinician planning to expand your practice or a client looking to continue therapy after a move, checking state-specific rules—and watching Counseling Compact developments—will help you stay informed and compliant.
Resources:
Your state’s behavioral health licensing board
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