What licenses give authority to diagnose mental health conditions in a state?

Mental Health Diagnostic Authority by License Type

The authority to diagnose mental health conditions is determined by individual state licensing boards, with psychiatrists, psychologists, clinical social workers, psychiatric nurse practitioners, and licensed professional counselors typically authorized to diagnose, though specific scope varies significantly by state law. 1

Licensed Professionals Authorized to Diagnose

The following license types generally have diagnostic authority for mental health conditions, though you must verify with your specific state's licensing board:

Physician Licenses

• Psychiatrists (MD/DO) hold unrestricted authority to diagnose all mental health conditions in all states 1
• Full medical licensure is required in the state where services are provided 1, 2

Advanced Practice Registered Nurses (APRNs)

• Psychiatric-Mental Health Nurse Practitioners (PMHNPs) are authorized to diagnose mental health conditions and provide psychotherapy 3
• State Nurse Practice Act determines whether full practice authority, reduced practice, or restricted practice applies 3
• Certification from ANCC validates competency for psychiatric diagnosis across the lifespan 3
• Critical caveat: Holding PMHNP certification alone does not grant practice authority—state law supersedes national certification 3

Doctoral-Level Psychologists

• Licensed Psychologists (PhD/PsyD) are authorized to diagnose mental health conditions in all states 1
• State licensure requires completion of accredited training programs plus additional state-specific examinations or coursework 1

Master's-Level Clinicians

• Licensed Clinical Social Workers (LCSWs) typically have diagnostic authority, though scope varies by state 1
• Licensed Professional Counselors (LPCs) may have diagnostic authority depending on state regulations 1
• All 50 states and D.C. require continuing education credits for social work licensure renewal 1

State-Specific Verification Requirements

You must contact your state Board of Nursing, Board of Medicine, Board of Psychology, or Board of Social Work to obtain current scope of practice regulations 3. State licensing boards determine:

• Which professionals can diagnose mental health conditions 1
• Whether collaborative agreements are required for APRNs 3
• Prescriptive authority limitations for psychiatric medications 3
• Additional examinations or coursework required beyond accredited training 1

Cross-State Practice Considerations

Telemedicine Diagnostic Services

• Full licensure is required in the state where the patient is physically located during the telemedicine encounter, not where the patient resides 1, 2
• Some states allow limited licensure specifically for telemedicine services with scope restrictions 1, 2
• The Interstate Medical Licensure Compact streamlines multi-state licensure, with 18 states having adopted it as of 2017 1

Emergency Consultations

• Some states allow emergency telepsychiatry services without a license but with regulations on extent and frequency 1
• Most states allow consultations between physicians without reciprocal licensure 1

Common Pitfalls to Avoid

Do not assume certification alone grants diagnostic authority—state law always supersedes national certification for psychologists, social workers, and APRNs 3. For example:

• A Family Nurse Practitioner (FNP) cannot provide psychiatric diagnoses under FNP certification alone—this violates regulatory standards 3
• Practicing outside certified population focus requires separate PMHNP certification 3

Do not assume independent practice authority exists without verifying current state Nurse Practice Act provisions for APRNs 3. Many states require:

• Collaborative agreements with physicians 3
• Physical proximity requirements for collaborating physicians (though most states do not impose this) 3
• Specific credentialing procedures approved by hospital medical staff bylaws 3

Immediate Action Steps

Before providing diagnostic services for mental health conditions:

• Contact your state licensing board to obtain current scope of practice regulations and any collaborative agreement requirements 3
• Verify your certification remains current throughout the practice period if you are an APRN 3
• Review state Medicaid and commercial payer policies for billing by license type 3
• Confirm compliance with telemedicine laws if providing services across state lines, including DEA regulations for controlled substance prescribing 3, 4, 2