Behavioral Health Providers Overview

Behavioral health providers and peer support specialists serve people who seek help for a variety of mental health and substance use needs, in settings from prevention programs to community-based and inpatient treatment programs. Many types of behavioral health providers and peer support specialists exist to serve a variety of patients.

This page focuses on addiction counselors, licensed professional counselors, peer support specialists, and also nurse practitioners and physician assistants who can prescribe buprenorphine-containing products, after receiving a waiver from the federal Controlled Substance Act’s special registration requirements. Other provider types include clinical psychologists, psychiatrists, social workers, marriage and family therapists, addiction counselors, among others. The University of Michigan’s Behavioral Health Workforce Research Center provides a comprehensive report on scopes of practice for 10 behavioral health providers. In addition to the report, the center has developed an interactive map to compare the scopes of practice of the providers in the states.

The information on this site focuses on four areas of scope of practice for behavioral health providers: addiction counselor crendentialing, licensed professional counselors’ ability to diagnose, the authority for nurse practitioners and physician assistants to prescribe buprenorphine-containing products after receiving a waiver from the federal Controlled Substance Act’s special registration requirements, and peer support specialist certification.

Addiction counselors work with people who suffer from a range of substance use disorders (SUDs). A SUD can involve addiction to alcohol, opioids and other substances. Addiction counselors work in a variety of settings, including inpatient and outpatient facilities, sober living homes, hospitals or various community organizations.

An individual can enter the field of addiction counseling through multiple means, ranging from earning a certification with a high school diploma to becoming a licensed addition counselor through a behavioral health graduate or doctorate degree with an addiction treatment focus. The state where individuals earns their certification or license affects what treatments they can provide and to whom.

Many states offer multiple paths to the same credential. The credential can be obtained by earning either a master’s, bachelor’s or associate’s degree or a high school diploma. The greater level of education achieved may be substituted for some of the required practice. For example, a high school graduate may need six years of experience to receive the credential, while someone with a graduate degree only needs one year of experience. In addition, individuals who have received a graduate degree are more likely to be authorized to diagnose and practice independently.

The map on the right shows the level of education required for addiction counselors to achieve a credential. The number and types of credentials vary from state to state. Please click on a state to read about specific credentials.

Licensed professional counselors (LPCs) and other nonphysician mental health professionals provide most mental health services in the U.S., often working in community-based settings where psychiatrist shortages exist. In some states, LPCs are referred to as licensed mental health counselors. LPCs are typically master’s-degree mental health service providers, but may also hold a doctoral degree.

Licensed professional counselors’ authority to diagnose patients’ mental illness varies by state statute. Diagnosis is often important for further developing effective patient treatment plans based on individual needs. Without diagnostic ability, LPCs often must refer patients to other licensed professionals with authority to diagnose mental disorders (e.g., psychiatrists).

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), medication-assisted treatment (MAT), including opioid treatment programs, combines behavioral therapy and medications to treat substance use disorders. MAT is the use of FDA-approved medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. Some states are exploring changes to scope of practice policies to enable greater access to MAT, including the use of buprenorphine-containing products.

Buprenorphine is used as part of MAT for opioid addiction and treats opioid dependence and addiction by diminishing withdrawal symptoms and cravings. Federal laws and regulations provide a framework for medication-assisted treatment on which states may build and implement additional laws and regulations. State law related to nurse practitioners (NPs) and physician assistants (PAs) practice authority affects the ability of NPs and PAs to prescribe buprenorphine-containing products under the federal framework.

Under current federal law, physicians, NPs and PAs may receive a waiver from the Controlled Substance Act’s special registration requirement and prescribe and dispense buprenorphine-containing products for treating opioid use disorder (OUD) if the NP or PA is authorized under state law:

  • To prescribe Schedule III, IV or V controlled substances.
  • Has proper training or experience to treat and manage patients with OUD.
  • Unless authorized to practice independently, practices under the supervision of in collaboration with a physician who is certified, trained or permitted to treat and manage patients with OUD.

There may be instances where an NP or PA in a state has received a waiver to prescribe buprenorphine-containing products, yet the NP or PA’s scope of practice may not allow them to prescribe the MAT. For more information on states requiring supervision or collaboration requirements, please see the site’s practice authority map for NPs and the supervision map for PA.

The maps on the right shows the number of nurse practitioners and physician assistants who have obtained a waiver from the federal government to prescribe buprenorphine-containing products as of August 2018 and is based on SAMHSA’s Buprenorphine Treatment Practitioner Locator

Peer support specialists, an emerging health profession, provide behavioral health services, education, recovery support and connection to other services. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines a peer support specialist as a person who uses his or her lived experience of recovery from mental illness and/or addiction, plus skills learned in formal training, to deliver services in behavioral health settings to promote mind-body recovery and resiliency. Certification for peer support specialists varies among the states. Some states offer certification through a nonprofit entity. In other states, a state agency or specific board offers certification.

Peer support specialists may also be known as recovery support specialists, peer recovery support specialists, recovery coaches or peer coaches. Please click on your state to see how peer support specialists are identified in your state.

The maps on the right shows a comparison of all states and territories for the three policy areas described on this page. Choose a tab to explore different options. For more detailed information, please click on a state or territory.

For information on nurse practitioners, physician assistants and oral health providers, please use the practitioner links below the map.

Practitioner Links