Board for Licensed Professional Counselors, Licensed Marital and Family Therapists, and Licensed Clinical Pastoral Therapists
When completing the application process below, you will be required to submit an official transcript from the institution where you completed your education. The transcript must be mailed directly from the educational institution to the board office located at 665 Mainstream Drive, Nashville, TN 37243.
Applications
Applying for initial licensure from your professional licensing board has become a bit easier. For the past year, the Department of Health has been working on an online application process that will allow all health care professionals to apply online for an initial license and complete (and update as necessary) a practitioner profile mandatory for certain professions. The process is user friendly and convenient and even allows you to pay for your initial application utilizing a credit card, debit card or e-check. You will also be able to upload many of the documents required to complete your initial application! Please go to the initial application link below to begin the online process.
For mailing documents please send them to the Board for Licensed Professional Counselors, Marital and Family Therapists and Clinical Pastoral Therapists, 665 Mainstream Dr, Nashville TN 37243
Applications
- Professional Counselors Paper Application
- Electronic Application for Licensure as a Professional Counselor; Mental Health Service Provider Designation; Temporary License as a Professional Counselor with MHSP Designation
- Application to Request LPC Approved Supervisor Status
- Reinstatement Application (PH-4049)
Forms
- Licensed Professional Counselor Course Work Summary
- LPC Verification of Supervision Form
- LPC Out-of-State Verification Form
- Declaration of Citizenship (PH-4183)
- Criminal Background Check Instructions
- Electronic Mandatory Practitioner Profile Questionnaire for Licensed Health Care Providers (PH-3585)
- Declaration of Eligibility for Expedited Licensure Process for a Military Member (PH-4279)
- Declaration of Eligibility for Expedited Licensure Process for a Spouse of Military Member (PH-4280)
- Name and Address Change Request (PH-3619)
- Affidavit of Retirement From Practice in Tennessee (PH-3460)
Applications
- Marital & Family Therapists Paper Application
- Electronic Application for Licensure as a Marital and Family Therapist and/or Temporary Marital and Family Therapist
- Reinstatement Application (PH-4049)
Forms
- Marital and Family Therapist Course Work Summary
- MFT Verification of Supervision Form
- Declaration of Citizenship (PH-4183)
- Criminal Background Check Instructions
- Mandatory Practitioner Profile Questionnaire for Licensed Health Care Providers (PH-3585)
- Declaration of Eligibility for Expedited Licensure Process for a Military Member (PH-4279)
- Declaration of Eligibility for Expedited Licensure Process for a Spouse of Military Member (PH-4280)
- MFT Request for Temporary License Form
- MFT Upgrade from Temporary License to Full MFT License
- Affidavit of Retirement From Practice in Tennessee (PH-3460)
- Name and Address Change Request (PH-3619)
Applications
- Clinical Pastoral Therappists Paper Application
- Electronic Application for License as a Clinical Pastoral Therapist
- Reinstatement Application (PH-4049)
Forms
- Declaration of Citizenship (PH-4183)
- Criminal Background Check Instructions
- Elecrtronic Mandatory Practitioner Profile Questionnaire for Licensed Health Care Providers (PH-3585)
- Declaration of Eligibility for Expedited Licensure Process for a Military Member (PH-4279)
- Declaration of Eligibility for Expedited Licensure Process for a Spouse of Military Member (PH-4280)
- Affidavit of Retirement From Practice in Tennessee (PH-3460)
- Name and Address Change Request (PH-3619)