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Mental Health Counselor Associates

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 of the forms in this section will be found in the paper application are required for LMHCA applicants.
    • Forms C: Form C must be completed by the applicant and submitted to the board with your application or by upload, email, or mail.  If emailing or mailing, be sure to include your name on the document.
    • Form C-1: Form C-1 educational criteria definitions and does not need to be submitted to the Board.
    • Forms P and I: Practicum and Internship forms are to be completed using the instructions at the top of each form.  These forms must be submitted to the Board directly from the university and are not acceptable if submitted to the Board by the applicants.
  • 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, sent directly to the board from the college or university, from which you obtained your master degree, showing completion of 60 graduate credit hours and degree 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. Transcripts uploaded by the applicant into their accounts will not be accepted.
  • Verification of Licensure: If you hold a registration/license/certification to practice any health-related profession or occupation in another state or territory it must be sent to the Board.  Verifications must be submitted directly from the state of issuance.  States may email or mail us their verifications forms, or they may complete our verification form here.
    • If completing our form, the top section 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.

Temporary Permits

The Board may issue a temporary permit to practice as a LMHCA to an applicant applying to take the examination who submits the following:

  • A completed application including all supporting documentation that has been approved by the Board.
  • An additional fee of twenty-five dollars ($25.00) for the temporary permit

Applicants for the LMHCA 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 NCE examination during that time period. A temporary permit for the LMHCA can only be issued to applicants seeking approval through the State to take the NCE. If you have obtained approval through your school to take the NCE, you will not qualify for a temporary permit.

Repeat Examination Application Instructions

This checklist is for applicants who are seeking approval to retake the national examination. They must have already been approved to take the exam by our State, and did not pass the examination. The list below is shorter than the first application instructions, as the information would have been previously approved by the Board in the first application to take the exam.  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

—— 90 day wait 

Testing Accommodation Request - If you have a disability which may require some special accommodation in taking this examination, please request a Testing Accommodation Request Form from the Indiana Professional Licensing Agency by calling (317) 234-2054 or by email at pla8@pla.in.gov. If you are hearing or speech impaired, you may utilize the Indiana Relay System by calling 1-800-743-3333. If an accommodation is not requested prior to Board approval to take the examination, the Board cannot guarantee the availability of the accommodation on-site.

Examination Approval - Your approval will occur once 90 days have passed since you last took the national exam. You may apply before the 90 days; however, your exam approval will not occur until all items have been completed and 90 days has passed since you last took the exam. 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.