There are a couple of ways to be licensed as LCMHC in North Carolina.

If you are not licensed in any other state and have not done a graduate degree in counseling, the first step to getting licensed as a counselor is to attend a graduate program in counseling and get a masters degree.

Many states require that the program be accredited by CACREP, the organization that manages standards for counselor education programs and ensures that they all meet a minimum set of criteria. North Carolina has had this requirement since 7/1/2022.

The first step to licensure in North Carolina is to apply for your LCMHCA.

This requires completion of a graduate program; passing either the NCE, NCMHE, or the CRC exam; three references; a criminal background check; a professional disclosure statement; and other education and experience documentation. In North Carolina, people with their LCMHCA cannot work without an approved supervision contract on file with the board.

North Carolina requires that supervisors meet certain requirements, and some supervisors, like me, have their LCMHC-S license, indicating that they are licensed and approved as supervisors.

In order to be granted a full LCMHC, you will need 3,000 total practice hours, of which 2,000 must be direct client contact.

During the accrual of your hours, you must also accumulate 100 supervision hours. Of those 100 hours, 25% can (but does not have to) be in a group of 3-8 people, the others must be individual or triadic (two supervisees and a supervisor). Supervision must not occur for less than one hour per session and at no less than one hour of individual supervision or two hours of group per 40 hours worked.

In addition to the above, in order to apply for full licensure, you must also take the jurisprudence exam and update your professional disclosure statement, as well as submit additional documentation.

In North Carolina there are additional paths to licensure, including reciprocity with several states, as well as licensure by endorsement. These are for people licensed as counselors in other states, rather folks seeking licensure for the first time or with incomplete licensure in other states.

A professional disclosure statement is a document that North Carolina requires licensees to give to each client before providing services. This is the North Carolina version of informed consent. North Carolina has specific requirements and offers templates and instructions.

You must have 100 supervision hours, 25% of which can be group if you choose. 

Both are counselor licenses. This definition varies from state to state. In some LPC is a first level license that does not allow for diagnosis and in others it’s the full license. North Carolina used to use LPC as their counselor license designation, but have updated to LCMHC.

In general terms, a counselor supervisor is someone who supports the growth and development of a (often more junior) counselor.

Thus, counselors-in-training have supervisors during their clinical courses, both through their programs and at their sites.

From a licensure perspective, a counselor supervisor is someone who is responsible for the practice of a pre-licensed counseling professional.

Different states have different requirements for this, and some boards require that the supervisor have a specific designation or pre-approval. Some require the person to be a counselor, some allow for supervision by other licensed mental health professionals.

In North Carolina, one must be a “qualified clinical supervisor,” which means you meet certain criteria or are licensed as a LCMHC-S. Some mental health professionals can be approved based on their licensure, experience, and training in clinical supervision even if they are not LCMHC-Ss.

A lot of this will depend on location within North Carolina and setting.

The median annual salary for counselors in North Carolina was $51,790.

This job is predicted to grow faster than average in the future.

This is a great place to research and explore salaries and information for your particular area.

It’s important to note that this data combines mental health counselors with similar professionals. 

Yes and no. Like much of counseling, this is not a simple answer.

The word counselor itself is not a protected term. However, calling oneself a licensed counselor or licensed clinical mental health counselor (LCMHC) is protected. This means you cannot represent yourself as a licensed counselor unless you are one recognized by the board in that state.

You also cannot provide mental health counseling unless you are authorized to do so in the state you’re in.

There are other professionals who do counseling (think spiritual or religious leaders), but licensed clinical mental health counselor is a specific term, the permitted use of which is outlined in state statutes and laws. 

It is unlawful to represent oneself as licensed or imply licensure in this manner if you are not licensed.

These terms are often very specifically and clearly defined in statutes you can access from the board website.

Therapist is a broad and more generic term used by a variety of mental health professionals, as well as within other professions (think massage therapist or physical therapist). Someone who is an LCMHC may refer to themselves as a therapist. 

NCC stands for National Certified Counselor and it is a credential issued by the National Board for Certified Counselors. It’s important to remember that it is not a license and does not permit one to practice in a state or represent themselves as a licensed professional. 

North Carolina does have reciprocity agreements with a few states. As of February, 2025, these include South Carolina, Kentucky, and Tennessee.

In addition to reciprocity agreements, North Carolina offers the opportunity to apply for licensure by endorsement if you meet the qualifications. See information here.

North Carolina does not have a minimum requirement for the time it takes to get your license. However, you must not accumulate hours at a rate of more than 40 per week.

MFT stands for Marriage and Family Therapist/Therapy or a form of that phrase, depending on the state. Marriage and family therapists meet a different set of licensure requirements, though some graduate programs might meet educational requirements for either license, depending on electives and how the program is set up. 

To work with a client located in North Carolina, you must be licensed in North Carolina. Telehealth laws and rules vary by state. If you are working with a North Carolina client from out of state, you may also need to be licensed in the state where you are practicing at the time.

According to the US News and World Report, New Jersey, California, New York, Connecticut, and Washington, DC are among the highest paying states for mental health counselors. It’s important to account for cost of living when considering salaries in those locations. 

According to US News and World Report, the best paid 25% of mental health counselors in the US made $73,050 annually in 2022. While according to careeronestop data, the high end of the spectrum for annual salary was in the neighborhood of $89,920. It’s important to note that careeronestop includes other occupations in their data, aside from LPCs. 

This site has some interesting numbers, but always take sources like these with a grain of salt, especially when they don’t say where those numbers came from! These seem pretty high to me!

This can vary widely and depends on a number of factors.

Overhead, rates, insurance versus private pay, specialty, experience, and location can all affect how much a private practice therapist makes in North Carolina. For example, someone who works from home and only works online has less overhead than someone who rents office space.

Someone who works within a group private practice will have to give some portion of what they make to the practice itself, while someone who works for themselves or owns the group private practice will not.

That being said, ranges of mid $40K to close to $100K can be found.

It’s really important to understand the factors that influence that deeply before deciding if private practice is the best decision for you. In North Carolina you can own or operate a private practice if you are still pursuing your post-master’s supervised professional experience. So, someone with a LCHMCA could, in theory have their own, independent practice and pay for supervision.