Guide for Washington clinicians
From LMHCA to LMHC: getting credentialed after full licensure
Last reviewed: October 19, 2026
As an associate, you see insured clients under someone else's contracts: your agency's, your group's, or your supervisor's. Once your full license is issued, you can be credentialed in your own name. Insurers won't accept your application until the full license is active, but you can do most of the preparation ahead of time. Here's a timeline so you're ready on day one.
This guide uses counselors (LMHCA to LMHC) as the example. The same steps apply to marriage and family therapists (LMFTA to LMFT) and social workers (LSWAIC to LICSW).
First, when will you be eligible?
In Washington, full LMHC licensure requires at least 36 months of full-time counseling or 3,000 hours of postgraduate mental health counseling under a qualified LMHC supervisor. That includes at least 100 hours of supervision and 1,200 hours of direct counseling with clients. Graduates of CACREP-accredited programs get credit for 50 supervision hours and 500 experience hours. Counting your hours with your supervisor tells you roughly when to apply, and that date is what the rest of this timeline hangs on.
3 to 4 months before your license
- Decide where you'll practice. Joining a group, staying where you are, or starting your own practice changes how you're credentialed. In a group, the group's contracts usually cover you. In your own practice, you need your own.
- Decide how you'll bill. Insurers contract with the tax ID you apply under: your own name, or a business such as a PLLC. Switching later can mean redoing applications, so decide before you apply. An accountant or attorney can help with the business side.
- Choose your insurers. Start with the plans your clients actually have. If many of your clients are older adults, read our guide to Medicare enrollment.
- Get a malpractice quote for your own policy. Your employer's coverage usually only covers the work you do for them. Most insurers ask for at least $1 million per claim and $3 million total.
1 to 2 months before
- Get your CAQH profile current. CAQH is the online profile most commercial insurers pull your information from. Your employer may have started one for you. If so, it's yours and goes with you. Update your work history, education, and practice details now. CAQH asks providers to re-attest every 120 days. See our CAQH guide.
- Gather your documents: diploma, a CV with month and year for each job (with a short note explaining any gaps), malpractice certificate, and your practice address and hours.
- Check your NPI. You keep the same individual NPI for life. Make sure you can log in to the NPI system (NPPES) yourself, since some employers set it up for their staff.
The week your license is issued
- Update your NPI record with your new license number and your practice address. Your full license has its own license number, different from your associate one.
- Update CAQH with the new license and re-attest so insurers see the current information.
- Submit your applications to each insurer you chose. Premera, for example, tells associates to apply for credentialing as soon as their full license is active.
- Buy your malpractice policy, if it isn't already in place, before you see clients in your own practice.
The next few months
Insurers set their own timelines. Commercial plans commonly take 60 to 90 days, plus about 30 more for contracting. Apple Health often takes longer. Applications move faster with regular follow-up calls, since insurers often pause an application to ask for one missing item.
Until each contract is active, insurers generally won't pay for your sessions under your own name. Many new clinicians see clients privately in the meantime, or keep seeing insured clients through their current employer's or group's contracts.
Common questions
Can I apply before my license is issued?
Not to insurers. They need an active, full license. You can prepare everything else so you're ready to submit the same week.
Do I need a new NPI?
No. Same NPI, updated details.
Can my supervisor's practice bill for me while I'm still an associate?
Some insurers allow a practice to bill for an associate's sessions, with the associate listed on the claim, but the contract belongs to the practice. Rules vary by insurer, and Medicare is much more limited. See our Medicare guide.
How we can help
We handle the whole timeline for you: CAQH setup, NPI updates, insurer applications, and follow-up calls, with a status update every two weeks. Prices are listed on our homepage. The best time to start is a month or two before your license is issued.
Sources
- Washington Administrative Code: WAC 246-809-230, supervised postgraduate experience for LMHCs
- Premera: Behavioral health provider resources (associate billing and credentialing)
- CMS: Medicare for MFTs and mental health counselors
This page is general information, not legal or licensing advice. Licensing requirements are set by the Washington State Department of Health. Check with them about your situation.