Checklist: Licensed Mental Health Counselor
Complete the forms indicated below in the appropriate column for the type of education you have completed. Submit the forms, or request that they be submitted, to the Office of the
Professions at the address at the end of each form. In the space provided on the checklist below, record the date you sent or requested the form to be sent. More information on completing
the forms can be found on our web site at http://www.op.nysed.gov/prof/mhp/mhcforms.htm for licensure.
Checklist
To obtain a LMHC license, applicant must meet
requirements for A OR B.
To obtain a Limited Permit, which is valid for two years
from date of issue, applicant must also meet requirements
for C.
To obtain a LMHC license by endorsement of a LMHC
license issued in another jurisdiction, applicant must
meet requirements for D.
A. Graduate of a NYS
60-semester hour
Licensure-Qualifying
program in mental
health counseling or a
degree in clinical
mental health
counseling from a
program accredited by
CACREP under the
2009 standards*
B. Graduate of a
master’s or higher degree
in mental health
counseling, determined
by the Department to be
the substantial equivalent
of a NYS Licensure-
Qualifying program based
on individual transcript
review**
C. Limited Permit
To request authorization
to practice under
supervision of a
qualified supervisor in
an authorized setting
while meeting the
examination &
experience
requirements***
D. Endorsement of LMHC license
issued in another jurisdiction
Licensed as a LMHC in another
jurisdiction on the basis of comparable
education, supervised experience and
examination, as determined by
NYSED, and verification of at least 5
years of LMHC independent practice in
10 years prior to application in New
York
Required
Date Sent
Required
Date Sent
Required
Date Sent
Required
Date Sent
Form 1 Application for Licensure and fee
Form 2 Certification of Professional Education
with Section II, Part A filled out clearly and completely to identify the
graduate school and program completed.
Form 2 and supporting
documentation for A or B
must be received and
approved before the
Limited Permit
can be issued.
Form 2 Certification of Professional Education and official transcript
Have each graduate college/university you attended submit a Form
2 with official transcript and Form 2-INT for supervised internship.
Course syllabi or other supplementary documentation to determine
whether studies meet the substantial equivalence requirements.
Form 3 Verification of Other Professional Licensure/Certification
This form must be submitted directly by the licensing/certifying
authority.
Only if you
are/were
licensed in
another
jurisdiction
Only if you
are/were
licensed in
another
jurisdiction
Form 4. Applicant Experience Record of supervisor(s) submitting
verification of at least 3,000 hours of supervised experience in
mental health counseling & psychotherapy in NY or another
jurisdiction****
Form 4B. Certification of Experience for LMHC. Form must be
submitted directly by the supervisor. ****
Form 4E. Endorsement Experience Record of colleagues
submitting verification of LMHC practice in another jurisdiction
Form 4F. Certification of Licensed Experience by colleagues
verifying 5 or more years of LMHC practice in another
jurisdiction
Form 5 Application for Limited Permit and fee
NBCC National Clinical Mental Health Counseling
Examination***** after receipt of application, fee & NYSED
approval of education.
* A program must be accredited by CACREP under 2009 clinical mental health counseling standards, including a supervised internship in mental health counseling & psychotherapy. You can
access a directory of CACREP accredited programs at www.cacrep.org.
** An appropriately recognized program must be offered by a regionally accredited college or university in the US or be recognized by the appropriate civil authorities of the jurisdiction in which
the program is offered. School must submit transcript and verification of supervised internship in mental health counseling & psychotherapy for review.
*** The permit may be granted for two years; it may be extended for no more than two one-year periods upon submission of a new permit application & permit fee and justification. The permit
will only be issued for authorized setting(s) under qualified supervisor(s), as defined in Education Law and Commissioner’s Regulations.
**** At least one-half of the supervised experience requirement must be direct client activities, as defined in the Commissioner’s Regulations, in the same setting under the authorized supervisor.
***** If you passed the NCMHCE examination in another jurisdiction, you must request a score transfer from NBCC; scores submitted by applicants or jurisdictions are not acceptable. New
York will not accept examinations given under non-standard conditions (e.g., ESL arrangements for extra time or translating dictionary); such applicants will have to take the exam under
standard conditions. No other examination is acceptable.
Links to all forms may be found on our web site at http://www.op.nysed.gov/prof/mhp/mhcforms.htmfor licensure.
Detailed licensure information can be found on our web site at: http://www.op.nysed.gov/prof/mhp/mhcforms.htmor contact the Mental Health Practitioner Unit by calling 518-474-3817 ext.
592 or by email at opunit5@nysed.gov.
LMHC Checklist August 20, 2019.docx
