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Mental Health Professions Licensing Board
 
           
           
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If you know which application package you need, click on the title to retrieve the complete package or the individual form. To assist you in determining which method of licensure or certification you might select, click here.
 
APPLICATION PACKETS:RE-APPLICATION PACKETS
 For an Expired License
Addictions TherapyFor an Expired Certificate 
Provisional Addictions Therapist (PAT) 
Licensed Addictions Therapist by Completing ProvisionalINDIVIDUAL FORMS:
Licensed Addictions Therapist by Reciprocity (LAT) Information Change Request
Licensed Addictions Therapist as a 2nd License (LAT)List A & B
Certified Addictions Practitioner by Examination (CAP)Professional Reference
Certified Addictions Practitioner by Reciprocity (CAP)State License/Certification Verification
Certified Addictions Practitioner Assistant by Examination (CAPA)Supervision Agreement- Certified
Certified Addictions Practitioner Assistant by Reciprocity (CAPA)Supervision Agreement- Provisional
Training Evaluation- CAPA
 Transcript Evaluation- CAP
Clinical Social WorkTranscript Evaluation- LAT
Provisional Clinical Social Worker (PCSW)Transcript Evaluation- LMFT
Licensed Clinical Social Worker by Completing ProvisionalTranscript Evaluation- LPC
Licensed Clinical Social Worker by Reciprocity (LCSW)Verification and Evaluation of Supervised Experience
Certified Social Worker by Examination (CSW) 
Certified Social Worker by Reciprocity (CSW)ADDICTIONS THERAPY EXAMINATION INFORMATION
 NAADAC Examination Fact Sheet and Application
Marriage and Family Therapy 
Provisional Marriage and Family Therapist (PMFT) 
Licensed Marriage and Family Therapist by Completing Provisional 
Licensed Marriage and Family Therapist by Reciprocity (LMFT) 
  
Professional Counseling 
Provisional Professional Counselor (PPC) 
Licensed Professional Counselor by Completing Provisional 
Licensed Professional Counselor by Reciprocity (LPC) 

To assist you in determining which type and method of licensure or certification you might select, answer the question.

        
   Have you been awarded a master's degree in Counseling, Social Work, Marriage and Family Therapy or Addictions Therapy from an educational institution accredited by one of the regional or national institutional accrediting bodies recognized by the Council for Higher Education Accreditation (CHEA)?   
        


                
  Click Here For Yes     Click Here For No