What are reciprocity states for therapists?

What is a reciprocity state?

Reciprocity refers to the ability of licensed therapists to transfer or use their professional license to practice in another state. It also refers to meeting criteria to either obtain a license in a given state more easily or practice there temporarily.

It’s typically an agreement between two states that effectively allows a licensed professional to “transfer” their license to another state. Reciprocity only applies to mental health clinicians who already have an active license in one U.S. state (for example, you can’t get two state licenses when you first become a therapist).

Reciprocity varies widely based on both the state and the specific license type (for example, LCSW, LMHC, and LMFT). That’s because each license type has its own state-specific standards for required education, supervised hours, and exams.

License reciprocity vs. license endorsement for therapists

True reciprocity is relatively rare. More states allow for license endorsement, a more complicated process that involves an assessment process by the new state’s board. “Some states have straightforward processes, while others require additional steps, such as verifying hours, passing an exam, or meeting additional education requirements,” says Maddie Tong, a licensed therapist practicing in New York and New Jersey and Headway’s Senior Associate of Clinical Education.

Some states also have provisions for therapists who plan to practice there for a shorter period of time in extreme circumstances. For example, you may have a client with a young child that lives in another state. A provision could ensure you can continue seeing that client when they’re out of state without needing to get an entirely new license.

Which states have reciprocity for therapists?

Different states and license types have their own guidelines. For example, Florida offers licensure by endorsement for LCSWs, LMHCs, and LMFTs if they hold a license in good standing in another state with comparable requirements. Oregon and Washington have reciprocity agreements with each other, and Oregon also has pathways for experienced out-of-state clinicians.

The Counseling Compact, set to be in effect as of 2025, will allow LPCs from participating states to practice in other states without excessive review or extra requirements. So far, these U.S. states have agreed to be part of the Compact. Similarly, PSYPACT is a licensure compact for psychologists specifically that facilitates psychology services across state lines. Generally, clinicians simply apply for a compact privilege if they are licensed in one compact state and want to practice in another.

If you’re interested in reciprocity or endorsement and you’re not an LPC or psychologist, search for the state you’re considering and your specific license. For example, you could search “LMFT license reciprocity in Michigan” or “LCSW license endorsement in Florida.”

What to know about cross-state licensure

If you’re pursuing cross-licensure for the first time, or you want to continue practicing in multiple states, there are a few important steps to take.

Research state board requirements.

Visit your licensing board’s website to verify the requirements for a reciprocity or endorsement application. Some boards allow online applications for faster processing.

Understand required documentation.

The documentation you need to provide for cross-state licensure typically depends on the type of license you have and the state board you’re applying to. “Requirements often include proof of education, supervised experience, exam scores, and licensure in good standing,” says Tong.

Confirm education and training.

As with your primary practice state, your secondary license will typically require graduation from an accredited master's or doctoral program in counseling, psychology, social work, or a related field. Some states may require specific coursework or training hours in certain areas.

Many states also require therapists to accrue a certain number of supervised clinical hours post-graduation. This typically involves working under the supervision of a licensed therapist or counselor.

Pass licensure examinations.

You’ll likely be able to carry over the licensure examination you already completed to the new state you wish to practice in, thanks to cross-state agreements. However, some stays may require additional exams. These exams can include a national exam, such as the National Counselor Examination (NCE) or the Examination for Professional Practice in Psychology (EPPP), as well as state-specific exams.

Once licensed in multiple states, you must fulfill each state's requirements for license renewal, which often includes obtaining continuing education credits and adhering to ethical standards.

Apply for licensure.

After meeting the education, experience, and examination requirements, you can apply for licensure in each state. This usually involves submitting an application, transcripts, exam scores, proof of supervised experience, and any other required documentation

Stay informed.

Keep in mind guidelines for both reciprocity and endorsement can change rapidly. For example, during the pandemic, Tong says many state boards temporarily changed their guidelines to allow therapists to practice outside their state more easily. “Licensing laws and compacts will also likely evolve with the expansion of telehealth,” she says.

Professional associations, such as the National Association of Social Workers (NASW), American Counseling Association (ACA), and American Association for Marriage and Family Therapy (AAMFT), often publish updates on interstate compacts and licensure portability efforts.

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