Header

  Close Menu

Addiction Counselor - Examination

Application Checklist

Requirements: Detailed

Temporary Permits

Repeat Application Instructions

Application Checklist

This section is to be used by the applicant to ensure all requirements have been requested and/or submitted.  Please see the Requirements: Detailed section for more information.

—— Completed Application

—— Additional Forms

—— Application fee of $50.00

—— Name Change Documentation

—— Positive Response Documentation

—— Criminal Background Check Required

—— Official Transcripts

—— Verification of Licensure

Requirements: Detailed

  • Completed Application: Applications may be submitted online at MyLicense.IN.gov or completed by paper and mailed to our office.
  • Additional Forms: All additional forms required for each license type are found in the following supplemental form(s) document. Each individual form within the packets details the requirements and provides directions on how to complete then submit each form.
  • Application fee of $50.00:  Make checks or money orders payable to Indiana Professional Licensing Agency.  All application fees are nonrefundable.
  • Name Change Documentation: Documentation of any legal name change if your name differs from that on any of your documents. Documentation may include a copy of your marriage certificate or divorce decree.  You may upload, email, or mail the documentation for processing.
  • Positive Response Documentation: If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date, cause number, and disposition. Submit copies of court documents for each instance to support the statement. If malpractice, provide the name(s) of the plaintiff(s).  You may upload, email, or mail the documentation for processing.
  • Criminal Background Check Required:  An individual applying for a license shall submit to a national criminal history background check at the cost of the individual.  Please see the step-by-step directions on how to complete the fingerprinting process for your criminal background check by visiting www.in.gov/pla/3241.htm.
    • Criminal background checks must be obtained after you apply for your license with the Board and prior to the issuance of a license.  
    • A criminal background check completed prior to the submission of your application for licensure will not be considered valid.
  • Official Transcripts:  Applicants must submit official transcripts from each school listed on Form C, sent directly to the board from the college or university.  The transcripts from which you obtained your degree must show that all requirements for graduation have been met and the date the degree was conferred.
    • NOTE: Transcripts must be original, official transcripts sent directly to the Board from the university. Copies of transcripts, transcripts issued to applicants, or incomplete (not yet showing your degree has been granted) transcripts are not acceptable.
  • Verification of Licensure: Verification of any registration/license/certification to practice any health-related profession or occupation in another state or territory.  Verifications must be submitted directly from the state of issuance.  You may find the verification form here.
    • The top portion of this form should be completed by the applicant and sent to the appropriate state licensing board for their submission to the Indiana Professional Licensing Agency. The form may be duplicated if necessary. Other jurisdictions may charge a fee to verify licensure. You may wish to contact the state boards prior to your request for verification. You do not need to complete this form if you only hold licensure or certification in the State of Indiana.

Examination Approval: An applicant who has been approved by the Board to take the examination must take the examination within one (1) calendar year from the date of the initial Board approval. If the applicant has not taken the examination within one (1) calendar year from the date of initial Board approval, the approval will be invalid and the applicant must submit a new application and all required documentation must be resubmitted. No extensions will be granted.

Official Score Report: Upon completion of the ADC or Level II examination; results will be released to our office four (4) to six (6) weeks after the administration of the examination. If you passed the examination, your license will be issued. If you failed the examination, you will receive notification from our office via email that will include instructions on how to apply to retake the examination. Please allow 7 to 10 business days for our office to process examination results once they are received.

Temporary Permits

The Board may issue a temporary permit to practice as a LACA, LAC, LCACA or LCAC to an applicant applying to take the examination who submits the following:

  • A completed application for full licensure of the same type including all supporting documentation.
  • An additional fee of twenty-five dollars ($25.00) for the temporary permit.

Applicants for the LACA or LCACA examination are limited to only one permit.  Applicants will be granted a temporary permit for a period of one year once they are approved for the examination.   The temporary permit will remain valid for the one-year period even if you fail to successfully complete the examination during that time period.

Repeat Examination Application Instructions

This checklist is for applicants that have been approved by Indiana to take the examination, unsuccessfully taken the examination, and wish to try again.  The list below is shorter than the first application instructions because the Board has the previously approved application (with the remaining documents required by statutes and rules) on file.  Please see the Requirements: Detailed section for more information.

——Completed Application – Use paper repeat application

——Application fee of $50.00

——Positive Response Documentation

——Criminal Background Check Required

Examination Approval - Once your application to retake the licensure examination has been approved, information will be emailed to each individual explaining the registration process for the examination. It is your responsibility to register for the correct examination and complete the examination. An applicant who has been approved by the Board to retake the examination must take the examination within one (1) year from the date of the Board’s approval. If the applicant has not taken the examination within one (1) year from the date of the Board’s approval, the approval will be invalid and the applicant must submit a new repeat examination application with the required documentation. No extensions will be granted.