Rhode Island Board of Mental Health Counselors and Marriage & Family Therapists - Page 2
Completed Application with Cover Page - Applications are valid for 1 year from the day they are received at RIDOH.
If you are not licensed within the year you must submit a new application.
Check or money order (preferred), made payable (in U.S. funds only) to the RI General Treasurer in the amount
of $70.00 and attached to the upper left-hand corner of the rst (Top) page of the application. THIS APPLICATION
FEE IS NONREFUNDABLE. Please be advised that this is an application fee and includes the rst license only up
until the next expiration date. All Marriage and Family Therapist licenses expire biennally on July 1st of the even
Ocial transcript(s), with registrar’s signature and school seal from an accredited College or University (60 credits
required). CACREP Accreditation, if applicable No student copies will be accepted.
Score/Certication NCMHCE sent directly from the NBCC - Telephone 1-336-547-0607) (pertains only to applicants
who have previously sat for the national exam).
Statement(s) of Supervised Practice - These hours are to be accrued after 60 credits are completed. (including su-
pervisor’s resume) (Form included in this application to be used for that purpose) If you are applying for the MHC
license by endorsement and your original practice supervisor is no longer available to complete the RI Statement
of Supervised Practice form, please have your original state of licensure send a copy of your original supervised
practice form from your original license or have the state verify your supervision and submit in a sealed envelope.
If you have ever been licensed in another state, license verication(s) must be sent directly from the state(s) in
which you hold or have held a license. (Interstate Verication Form included in this application can be used for that
If applying for expedited military status you must include one of the following: Leave Earning Statement (LES), Let-
ter from Command, Copy of Orders or DD-214 showing honorable discharge.
The exam required for licensure is the National Clinical Mental Health Counselor Exam (NCMHCE). The National Board
of Certied Counselors (NBCC) is the national certication agency, which owns/administers this exam. Upon receipt of
your completed license application, HEALTH will register you with NBCC for the next scheduled exam. You will receive
notication of exam admittance, location, directions, etc. from NBCC approximately ten (10) days prior to the exam date.
NBCC sends exam results to HEALTH (not individual applicants) in approximately six (6) weeks. HEALTH will then
forward your exam results to you.
For exam information, including exam dates, the preparation guide and other study materials, please refer to the NBCC
Please visit the RIDOH website at http://www.health.ri.gov/licenses to Verify your license, download Rules
and Regualtions/Laws for your profession, download change of address forms, other licensing forms or obtain
our contact information. HEALTH will not, for any reason, accelerate the processing of one applicant at the ex
pense of others.
RIDOH will be providing wallet license cards ONLY on issuance of licenses. If you wish to receive a license cer-
ticate, suitable for framing, please check the box below and attach a separate check in the amount of $30.00
made payable to RI General Treasurer.
I would like to receive a license certicate. I have enclosed a separate check in the amount of $30.00