As in some other states, counselors in Iowa are known as Licensed Mental Health Counselors (LMHCs). The premier professional organization for LMHCs in the state is the Iowa Mental Health Counselors Association, a local chapter of the American Mental Health Counselors Association dedicated to “meeting the professional needs of mental health counselors in Iowa.”

Licensure for LMHCs in Iowa is managed by the state Board of Behavioral Science. Licensure requirements for counselors in Iowa, including those relating to education, supervision, examination, fees, and renewal, are examined in further detail below, along with salary information from the U.S. Bureau of Labor Statistics as well as public and private scholarships available to aspiring LMHCs in the state.

As of July 1, 2024, the Iowa Board of Behavioral Sciences merged with the Iowa Board of Social Work and the Iowa Board of Psychology to form the Iowa Behavioral Health Professionals Board, operating under the Iowa Department of Inspections, Appeals, and Licensure (DIAL). 

LMHC licensure in Iowa requires the completion of a master’s degree of 60 semester hours or a doctoral degree in counseling with emphasis in mental health counseling from a program accredited by the Council on Accreditation of Counseling and Related Educational Programs (CACREP) from a college or university accredited by an agency recognized by the United States Department of Education according to Iowa DIAL, Apply for a Mental Health Counselor Permanent License (updated May 2025):. Alternatively, a non-CACREP-accredited counseling program that is content-equivalent may be accepted, according to Iowa Administrative Code 481-891.6.

In addition to the coursework listed above, LMHC licensure in Iowa requires both a practicum and an internship. A practicum is graduate-level clinical supervised counseling in a mental health setting in which students complete supervised experiences that total at least 100 clock hours over at least a 10-week academic term. It must also include at least 40 hours of direct service with clients, an average of 1 hour per week of individual or triadic supervision, and 1.5 hours of group supervision.

Six hundred clock hours of graduate-level clinical supervised counseling internship in a mental health setting are also required following completion of the practicum. This must include at least 240 hours of direct service with clients, an average of 1 hour per week of individual or triadic supervision, and 1.5 hours of group supervision. These internship hour requirements are confirmed by Iowa Administrative Code 481-891.6.

Both the practicum and the internship are distinct from “Supervision.”

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“Supervision” is shorthand for post-degree, directed experience in professional counseling under supervision in a work setting. Iowa requires applicants for licensure as a mental health counselor to complete at least 3,000 hours of work experience in mental health counseling in at least two years. Of those 3,000 hours, at least 1,500 must be in direct client contact. According to Iowa House File 2515, signed into law on April 19, 2024, the clinical supervision hour requirements were revised. As of 2024, at least 110 hours of direct supervision must be equitably distributed throughout the supervised experience and include at least 24 hours of live or recorded direct observation of client interaction. A maximum of 50 of those hours may be obtained through group supervision, per the Iowa Mental Health Counselors Association (IMHCA). The supervisor may be an LMHC or a Licensed Marriage and Family Therapist (LMFT) with at least 3 years of post-licensure clinical experience in Iowa, or an equivalent mental health professional.

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Licensure as a mental health counselor in Iowa requires a passing score on either the National Counselor Examination for Licensure and Certification (NCE) or the National Clinical Mental Health Counselor Exam (NCMHCE).

National Counselor Examination (NCE) for Licensure and Certification

The NCE is a 200-question multiple-choice examination administered by the National Board for Certified Counselors. It assesses knowledge, skills, and abilities in effective counseling services.

National Clinical Mental Health Counselor Exam (NCMHCE)

The NCMHCE tests knowledge of assessment, diagnosis, counseling, psychotherapy, administration, consultation, and supervision. According to the NBCC (updated in 2022 and currently in effect), the exam consists of 11 case studies — 10 scored and 1 unscored — each comprising a clinical narrative followed by a set of multiple-choice questions divided into three sections. The exam assesses an entry-level counselor’s ability to apply knowledge across four domains: Professional Practice and Ethics; Intake, Assessment, and Diagnosis; Treatment Planning; and Counseling Skills and Interventions. It is also administered by the National Board for Certified Counselors.

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LMHCs in Iowa can apply online for a permanent Mental Health Counselor license. The application fee is $120. All application fees are nonrefundable.

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LMHC licenses in Iowa expire biennially on September 30th of each even-numbered year. License renewal requires payment of the appropriate renewal fee (see above) and completion of continuing education. Licenses issued within six months of the renewal date do not need to be renewed until the next renewal date.

LMHCs in Iowa must complete at least 40 hours of continuing education during the 24-month renewal period to successfully renew their licenses, per Iowa Administrative Code r. 481-892.2 (effective June 5, 2024). This requirement is waived for newly licensed LMHCs for their first renewal, although CE hours accrued from initial licensing through the second renewal may be applied. According to the Iowa Behavioral Health Professionals Board, of the 40 required hours, a minimum of 3 hours must be in ethics, and licensees serving in a supervisory role must also complete 3 hours in supervision practices. Additionally, per NetCE (2024), mandatory reporters must complete a 2-hour core training curriculum every three years beginning July 1, 2024. All 40 hours may be obtained by attending workshops, conferences, symposiums, and academic courses (one academic semester is equivalent to 15 CE hours). Alternatively, up to 20 hours may be obtained through presenting professional programs, conducting scholarly research, publishing in a refereed journal, attending distance-learning conferences or courses, or completing home-study courses.

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For Counselors Licensed in Other States

The Iowa Behavioral Health Professionals Board offers an alternative licensure route for counselors who have already obtained licensure in other states. This process is known as “licensure by endorsement.” Per Iowa Administrative Code Rule 481-880.5(154D), applicants for licensure by endorsement must provide verification of current licensure sent directly from the issuing jurisdiction to the Iowa Behavioral Health Professionals Board and disclose any public or pending disciplinary complaints.

Additionally, as of December 2025, Iowa is a member of the interstate Counseling Compact, which offers an alternative pathway for eligible LMHCs. Compact members do not need to obtain a full second license; instead, they may apply for a “privilege to practice” under their home state license.

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According to wage data from the U.S. Bureau of Labor Statistics’ Occupational Employment and Wage Statistics (OEWS) Maps: Iowa, the following counselor occupations in Iowa report the following median annual wages:

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The following scholarships and loan repayment programs are available to aspiring LMHCs in Iowa:

Iowa Mental Health Counselors Association (IMHCA) Scholarship

Scholarships for Disadvantaged Students

National Health Service Corps Loan Repayment Program

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*Licensure information, including requirements, salaries, renewals, scholarships, and fees, was retrieved as of March 2026. Information may have changed since; check with the state’s board of licensing for more information.

Information last updated: March 2026