Multi-state licensure can be a complicated process for behavioral health providers. Understanding the state-specific regulations and requirements for gaining licensure will help you expand your practice into new states more easily.
Behavioral health professionals nationwide are obtaining multi-state licensure for several reasons. Whether you’re looking for more earning potential in telemental health, want to reach people in rural communities, or wish to continue treating clients outside your state of licensure, becoming licensed in multiple states can be the key.
When practicing virtual mental health care, providers need to be licensed in the state where the client is located.
This makes it tricky to provide ongoing care when you or your clients move to a new state, go on vacation, or relocate for school.
Obtaining licenses in new states allows you to continue treating your established clients and reach more people in need, but there is no singular streamlined process for procuring a new license. Unfortunately, the laws and requirements for licensure vary from state to state for counselors, social workers, marriage and family therapists, and psychologists.
Understanding the minimum requirements to be legally permitted to practice in new states can be difficult and the path to licensure is largely unique to each individual.
Thankfully, there are resources available to help you determine the wide range of requirements and documentation you’ll need to expand your practice.
State licensure overview for telemental health professionals
State boards can have unique requirements for each behavioral health license type relating to credentialing, education, exams (including jurisprudence), supervision, licensure renewal, and adherence to the ACA’s Code of Ethics.
These are the typical pieces of documentation state boards require for licensure:
- Application. The application for licensure often requires a master's degree in counseling with proof of a passing test score and specific coursework, among other requirements. Fingerprinting and background checks may be requested depending on the state.
- Licensure scores. Applicants are required to obtain and submit a certified copy of their scores for the specific exams recognized by the state board. Most states accept the national board exam, but you may need to complete additional testing. Commonly accepted exams include the NCE, NCMHCE, CRCE, and ECCP. You may also be required to pass a jurisprudence examination to demonstrate your understanding of the specific state’s practice restrictions and guidelines.
- Sealed transcript. State boards typically require a sealed transcript from your accredited school of practice. This may need to be sent directly from the institution while some states allow you to send in a sealed copy yourself.
- Documentation of supervision hours. Providers are required to submit documentation of supervision that meets the minimum amount of supervised hours within a certain time period, as designated by the state. To ensure your hours will be accepted, check with the board to see what type of supervised work qualifies.
Tips for streamlining the licensure process
If you are planning to apply for more than one state license, it can be easier and more cost-effective to obtain everything you need in multiples.
For example, if the states require fingerprinting, obtain all fingerprint documents needed (some states require fingerprints on a state-specific form) and complete fingerprinting for all states at the same time and at the same place.
For transcripts, request extra sealed copies so you have duplicates on hand. File them away for the next time you need to submit them.
Where should mental health professionals get licensed for telehealth?
While demand for mental health services is high across the country, some states can provide a greater volume or diversity of work opportunities due to the sheer number of patients requesting care compared to the volume of mental health providers actively licensed in the state.
Typically, states with more cumbersome licensure processes can be valuable. This includes states like California and New York.
Also, states with larger populations can be safe bets. This includes California, Texas, Florida, New York, Pennsylvania, Illinois, and Ohio.
Above all though, simply investing in a few state licensures, regardless of location, can make you an attractive candidate for telehealth opportunities.
Resources for navigating the state licensure process by license type
Below are resources to help you understand the state licensure requirements for your license type.
Mental Health Professionals Facebook group
Multi-State Licensing for Mental Health Professionals - This group is not affiliated with Wheel, but is moderated by one of our webinar panelists. Join the group to engage with other professionals providing services in multiple states, share licensure tips, and ask questions about others’ experiences with state licensure.
LCSW licensing resources
ASWB State Requirements Database - If you are unsure where to get started, this tool is a good place. Access links to all state board websites, view and compare specific state licensure requirements, view and compare specific state CME requirements, and build your own comparison report for download.
NASW CE Tracker - Track renewal deadlines and continuing education programs.
LPC licensing resources
ACA Directory of State Licensure Boards - Find links to each state’s licensure board for more information on specific state requirements.
News: Maryland and Georgia Join Interstate Counseling Compact - Two states have signed on to join the interstate compact for LPCs. Ten states are needed to enact the compact, but this momentum is good news for counselors looking for state reciprocity in the future.
LMFT licensing resources
AMFTRB State Licensure Comparison - Compare licensure by state including education requirements, experience, supervision, portability, and fees.
AMFTRB State Requirements - View FAQs and information about moving states, procuring licensure across states, and specific California requirements.
AMFTRB State Board Index - Find contact information for licensure boards in each state.
Psychologist licensing resources
ASPPB PSY|Book: Licensing Requirements by State - Use this interactive map to view licensure requirements for each state of interest.
ASPPB Credentials Bank - Verify and store your transcripts, supervision documents, exams, reference letters, and other credentials for your entire career.
PSYPACT - Practice telepsychology in 24 compact member states.
Can I continue to see my patients while I’m on vacation in another state?
Telehealth regulations require the clinician to be licensed in the state the PATIENT is located in at the time of service. That means if you are licensed in Texas, and travel to Michigan for the summer, you can continue to see your Texas patients as long as they are physically located in Texas.
Can I continue to see my patients while they are on vacation in another state?
Telehealth regulations require the clinician to be licensed in the state the PATIENT is located in at the time of service. That means that if your patient or client travels to another state where you are not licensed, you may not provide services unless otherwise permitted by a waiver or other special regulation.
How can I determine need in specific states?
The Health Resources and Services Administration provides a database of health professional shortages areas where you can determine provider need for population types in specific territories. Find the database tool here: HPSA Find and the map search tool here: HPSA Map Gallery.
How long does it take to get state licensure?
The timeline for licensure is unique to each individual and is dependent on state. The process can take anywhere from a few months up to six months if the state receives a high volume of applications. When contacting state boards for information, speak with a director or other official officer who is familiar with the latest requirements and intricacies of licensure in that state to prevent delays due to misinformation.
How much does state licensure cost?
Throughout the licensing process, you can expect to pay a few hundred dollars or more. Depending on the state, total cost for obtaining licensure can include fees required for application and registration, limited permit applications, fingerprinting, transcript requests, annual continuing education credits, additional exams, etc. Check with the state board to gain a greater sense of how much licensing will cost you.
Do continuing education credits transfer across states?
Each state requires annual continuing education to maintain active licensure. It’s beneficial to seek additional licenses in states that have similar requirements and will accept the same continuing education credits. This will help limit the number of different CEU credits you will need each year to maintain licensure across your state licences.
For more information, watch our recent webinar on multi-state licensing 101 for psychotherapists.
Looking for a simpler way to practice telemental health?
Wheel connects behavioral health professionals with a variety of high-quality telehealth opportunities on one platform.
With just one application, one credentialing effort, and one schedule, psychotherapists can begin working with clients and patients across multiple digital healthcare companies in all regions of the United States. A great opportunity for providers with multi-state licensure.
Learn more about working in virtual care through Wheel.