Starting a practice
What are reciprocity states for therapists?
Here’s how reciprocity allows therapists to practice outside the state they’re licensed in.
January 3, 2025 • Updated on November 24, 2025
6 min read
Your therapy license allows you to see clients in the state where you received the license. If you practice virtually, you may want to practice therapy with clients who live outside your state to grow your practice or continue supporting someone after a move.
One option is reciprocity, which allows therapists to practice outside the state they’re licensed in. Each license type and state has different requirements for reciprocity, so it’s important to pay close attention to requirements and guidelines for transferring your professional license.
Below, learn more about reciprocity states for therapists and how you can expand your practice to another state.
Key takeaways
- Reciprocity is a system that allows a therapist licensed in one state to also practice in another.
- To get reciprocity, you’ll have to apply and make sure you meet licensure requirements in the new state. (Remember, requirements vary by state and license type.)
- When you’re ready to practice across borders, Headway is here to support everything from credentialing to client communication.
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.
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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.
Common reciprocity misconceptions
Assuming that reciprocity is automatic is among the most common — and important — misconceptions about the process. Don’t expect to begin practicing in a new state without jumping through some administrative hoops. Even in states that have enacted the Counseling Compact, for example, counselors must still apply for the right to actually take advantage of that agreement.
Although agreements like the Counseling Compact and PSYPACT are meant to simplify things, it’s important to leave plenty of time to navigate the application process. It can take quite a while to understand and fulfill a new state’s requirements, to say nothing of potential paperwork and processing delays. While some states have more straightforward processes than others, it can take months on end to actually get the approvals you need.
It’s also a mistake to assume that practice requirements will be the same from state to state. Even if you’re fully licensed and experienced in your home state, you may need to go through additional training or supervision to practice in the same capacity elsewhere. Make sure you understand exactly what’s required so there are no surprises along the way.
How Headway supports your practice in multiple states
Whether you practice in one state or a dozen, Headway is here to make your life easier. Our EHR, which is equipped with a secure telehealth platform, makes it easy to schedule appointments, carry out sessions, and stay in touch with clients, no matter where they’re located. Our team is also here to help with fast and free credentialing when your practice is ready to cross state lines. Interstate practice can be a head-spinning process. Let Headway handle the details so you can focus on providing great care, everywhere.
This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
© 2025 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.
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