How to start a private mental health practice in Florida

How do you start a private practice in Florida?

File in this order, since most rows need one above them. The entity, the EIN and the local permits work as they do for a medical office (how to start a medical practice).

Sources: DOH; Sunbiz; IRS; 45 CFR 162.410; City of Miami; Miami-Dade Tax Collector; DataSpring user guide v46.0; First Coast; AHCA; credentialing cost; Evernorth; read Oct 20, 2026.

Which licenses do you need when starting a therapy private practice?

Beyond your own license, two facility licenses have exemptions that reach chapter 491 practices, each on its statute’s terms:

• AHCA clinic license. Paragraph (g) of s. 400.9905(4) lists chapter 491 among the licenses whose holders can wholly own an exempt practice, alone or with a spouse, parent, child or sibling, “if one of the owners who is a licensed health care practitioner is supervising the business activities and is legally responsible for the entity’s compliance with all federal and state laws.” With any other owner, and no other exemption in s. 400.9905(4), the practice needs the clinic license, a $300 assessment every 2 years and a medical or clinic director (s. 400.9935(1)). The optional Certificate of Exemption costs $100 or less, after you post self-pay prices covering at least your 50 most frequent services (s. 400.9935(6)); AHCA licensing has the application.
• DCF substance abuse license. Beyond the exemption in subsection (7), s. 397.4012 says chapter 397 doesn’t limit a chapter 491 psychotherapist who treats substance use, so long as he or she doesn’t represent to the public as a licensed service provider and doesn’t serve people under part V, the involuntary-admission procedures; failing any requirement of exempt status is a first-degree misdemeanor. How that applies to the services you plan is a question for your attorney.
• Your license on the wall, your title in print. Display the license, or a true copy, “at each location” where you practice, and put “LCSW,” “LMFT” or “LMHC” (or the full title) on “all promotional materials, including cards, brochures, stationery, advertisements, and signs” (s. 491.0149(1)). Interns use the full words, such as “registered mental health counselor intern” (s. 491.0149(2)(b)).

Can an LCSW start a private practice right after licensure?

Yes, once DOH’s license search shows the license as Clear/Active: a licensee “may practice a profession only if the licensee has an active status license” (s. 456.036(1)); see how to verify a Florida license. A registered intern can work in your practice, but not alone:

“A licensed mental health professional must be on the premises when clinical services are provided by a registered intern in a private practice setting.”

Since July 6, 2026, Rule 64B4-2.002(8) counts that professional as on the premises when available to the intern by telehealth or another synchronous electronic means, if the telehealth protocol and safety plan between the intern and their qualified supervisor address it. Payers want an independent license: Evernorth asks for “A license to practice independently (without supervision),” and Medicare’s MFT and MHC benefit requires a state license and 2 years or 3,000 hours of supervised experience after the master’s degree.

Florida had 12,257 registered interns at June 30, 2026: 6,018 in mental health counseling, 5,396 in clinical social work and 843 in marriage and family therapy (DOH).

How do you get paid when starting a mental health business?

• Medicare. LCSWs, and since Jan 1, 2024 LMFTs and LMHCs, bill Medicare in their own name on the CMS-855I, at 75% of the physician fee schedule amount, every claim on assignment (Medicare enrollment).
• Florida Medicaid. Full enrollment as a Specialized Therapeutic Services provider requires a link to a community behavioral health services group; limited enrollment, for joining Medicaid health plans’ networks, needs no link (AHCA Enrollment Policy, Appendix C, p. 74). For fee-for-service therapy, AHCA’s coverage policy says: “All providers that deliver behavioral health therapy services must be either employed or contracted with a community behavioral health agency” (Rule 59G-4.052, §3.2). Florida Medicaid enrollment covers both routes.

Can a therapist starting a private practice see clients in other states?

• Inside Florida, telehealth needs nothing extra: DOH says “Current Florida licensees are able to provide telehealth services to patients in Florida without additional licensure.”
• A clinician licensed elsewhere can treat your Florida clients by telehealth only after registering with DOH, and a registered provider “may not open an office in this state and may not provide in-person health care services to patients located in this state” (s. 456.47(4)(a), (f)).
• Clients in another state: Florida enacted the Professional Counselors Licensure Compact in 2022 (s. 491.017; ch. 2022-63). It covers counselors, defined as “a counselor licensed by a member state, regardless of the title used by that state, to independently assess, diagnose, and treat behavioral health conditions” (art. II(15)).

What you can do today: a checklist for starting a counseling private practice

1. Save a dated copy of your license page from DOH’s license search for your credentialing files.
2. Ask your city’s zoning office whether a therapy office may open at the address before you sign a lease.
3. File the LLC on Sunbiz, then the EIN on IRS.gov in one session (it expires after 15 minutes of inactivity), then your Type 2 NPI in NPPES (NPI and CAQH setup).
4. Build and attest your CAQH profile, then authorize each plan before you apply to it.
5. File the CMS-855I in PECOS and choose your Medicaid route from the payment section above.

Advixor credentials LCSWs, LMFTs and LMHCs with commercial health plans, Medicare and Medicaid, solo or in groups (mental health credentialing).