What Do The Letters After a Therapist's Name Mean? Understanding Therapist Credentials in North Carolina.

When you search for a therapist in Morrisville, Raleigh, Cary, Durham, Apex, or anywhere in the Triangle, you’ll often see a string of letters after their name – like Ph.D., Psy.D., LCMHC, LCSW, LMFT, LCAS. In short, these letters are all titles and they are based on their levels of education and what specific area they practice or are licensed in [1].

If you’re not familiar with these, it can feel confusing. In short, those letters are credentials that indicate the therapist’s education, license, and specialty area. Just as doctors or lawyers have titles that reflect their training, therapists do too.

This guide will help you decode the alphabet soup of therapist credentials. We’ll explain the North Carolina–specific licenses, highlight out-of-state equivalents you might have seen elsewhere, and introduce specialty certifications you may come across.

By the end, you’ll have a clearer sense of what those letters mean—and which type of therapist might be right for you.

Find out more about what exactly a Therapist does, here.

Quick Reference: Common Therapist Credentials (Degrees & Licenses)

Letters	Full Title	What It Means
Ph.D.	Doctor of Philosophy in Psychology	Doctorate focused on research + therapy. Licensed psychologists can diagnose and treat.
Psy.D.	Doctor of Psychology	Doctorate focused on clinical practice (therapy, assessments).
M.D. / D.O.	Psychiatrist (Doctor of Medicine / Osteopath)	Physicians specializing in psychiatry. Can prescribe medication.
M.A. / M.S. / M.Ed.	Master of Arts / Science / Education	Graduate degrees in counseling or psychology. Foundation for licensure.
M.S.W.	Master of Social Work	Graduate degree in social work. Often leads to LCSW licensure.
LCSW / LCSWA	Licensed Clinical Social Worker / Associate (NC)	MSW graduates licensed for therapy. “A” = associate under supervision.
LCMHC / LCMHCA	Licensed Clinical Mental Health Counselor / Associate (NC)	NC’s counseling license. Equivalent to LPC/LMHC in other states.
LMFT / LMFTA	Licensed Marriage & Family Therapist / Associate (NC)	Focus on couples, families, and relational dynamics.
LCAS / LCASA	Licensed Clinical Addiction Specialist / Associate (NC)	Specialists in treating substance use and addiction.
LPC / LMHC / LCPC	Licensed Professional Counselor / Mental Health Counselor (out-of-state)	Equivalent to NC’s LCMHC.
LICSW / LISW	Licensed Independent Clinical Social Worker (out-of-state)	Equivalent to NC’s LCSW.
LADC / CADC	Licensed/Certified Alcohol & Drug Counselor (out-of-state)	Equivalent to NC’s LCAS.
PMHNP-BC	Psychiatric Mental Health Nurse Practitioner, Board Certified	Nurse practitioners who can prescribe psychiatric meds.
CPC	Certified Professional Coach	Coaching certification, not a therapy license. Focus on personal growth.

Doctoral-Level Clinicians: Psychologists and Psychiatrists

Ph.D. – Doctor of Philosophy in Psychology

A Ph.D. psychologist has a doctorate with a heavy emphasis on research and academic knowledge. Still, most are also fully trained to provide therapy, conduct testing, and treat a wide range of mental health disorders. In NC, once licensed, they may use the title “Licensed Psychologist.”

Psy.D. – Doctor of Psychology

The Psy.D. is a doctorate with greater focus on clinical practice. Psy.D. psychologists often work directly with clients in hospitals, clinics, and private practice.

Tip: For most people seeking therapy, a master’s-level clinician (LCMHC, LCSW, LMFT) is perfectly suited. A psychologist may be helpful if you need specialized testing or research-based treatments.

M.D. / D.O. – Psychiatrists

Psychiatrists are medical doctors who specialize in mental health. In NC, they’re licensed by the North Carolina Medical Board. They can prescribe medication, which most therapists cannot. Some also provide therapy, though many focus on medical management while collaborating with counselors.

Master’s-Level Therapists and Degrees (M.A., M.S., M.S.W., M.Ed.)

Most therapists and counselors are required to have at least a master’s degree in a relevant field. Master’s-level clinicians form the backbone of therapy services – they include licensed counselors, social workers, and marriage/family therapists. Here are common master’s degrees you’ll encounter:

• M.A. (Master of Arts) / M.S. (Master of Science): 

  • These denote a master’s degree in a field like psychology, counseling, or a related mental health discipline. The difference between an MA and MS is usually the academic focus (Arts vs. Science), but in practice they are equivalent levels of education (typically 1.5 to 3 years of graduate study after a bachelor’s). For example, someone with Jane Smith, M.A. might have a Master of Arts in Counseling Psychology, whereas John Doe, M.S. could have a Master of Science in Clinical Psychology. Both signify a graduate-level education. Many therapists will list their master’s degree (M.A. or M.S.) alongside their license. These degrees include coursework in therapy methods, human behavior, ethics, etc., and require practical internships. After earning an MA or MS, the individual can pursue licensure (like LPC, LCSW, etc., described below).

• M.Ed. (Master of Education): 

  • In counseling, an M.Ed. often indicates a master’s degree in Education with a focus on Counseling (sometimes called Counselor Education). Some universities house counseling programs in the education department, granting an M.Ed. instead of an M.A. or M.S. Functionally, an M.Ed. in Counseling covers similar clinical training. Therapists with an M.Ed. have the same level of education (master’s) as those with an M.A./M.S. They may work as school counselors or in private practice, depending on the specialization.

• M.S.W. (Master of Social Work): 

  • This is a master’s degree specifically in social work. Social workers are trained not only in counseling techniques but also in understanding social systems, community resources, and social justice issues. An MSW program includes both clinical training and macro-level social work topics. Therapists with an MSW often go on to become licensed clinical social workers (LCSW). In a counseling context, someone with an MSW can provide therapy, particularly after obtaining a clinical license, but they also bring a perspective on how societal and environmental factors affect mental health. MSWs can work in a variety of settings: from hospitals and community agencies to private therapy practices.

Master’s-level credentials by themselves (M.A., M.S., M.Ed., M.S.W.) are academic degrees, not licenses to practice independently. After earning a master’s, a therapist typically pursues state licensure (such as LPC, LCSW, etc.).

Below, we cover the common licenses you’ll see, which indicate the therapist has met state requirements (like supervised experience and exams) to practice.

Licensed Therapists and Counselors (Common Licenses)

Licensed therapists have both an educational degree (usually master’s or doctorate) and a professional license from a state board.

The license is what legally allows them to practice therapy independently and is usually represented by a set of letters like those below.

These licenses often correspond to the therapist’s specific training or client focus. Let’s group the major types of licenses:

LCSW – Licensed Clinical Social Worker (and Related Titles)

LCSW stands for Licensed Clinical Social Worker. This means the therapist has an MSW (Master of Social Work) degree and has completed additional supervised clinical hours (and passed licensing exams) to become a licensed social worker in a clinical setting.

LCSWs are trained to provide therapy for mental health issues, and they also consider social and community factors in treatment. They might work with individuals on issues like depression or anxiety, but also help connect clients with community resources, address family dynamics, or navigate social services.

• Variations: 

  • Different states use slightly different titles for similar roles. You might see LICSW (Licensed Independent Clinical Social Worker) or LISW in some areas – these are essentially equivalent to LCSW, with minor differences in wording or scope. All indicate a licensed clinical social worker.

• LCSWA (Associate): 

  • In many states, new graduates initially become an LCSW Associate (sometimes called LMSW or simply an intern) while they gain required supervised experience. For example, LCSWA means the person is an Associate Licensed Clinical Social Worker, practicing under supervision. After completing the required hours (which can take a couple of years), they become a full LCSW. If you see an “A” at the end of a license (like LCSW-A), it generally means the person is in a training phase under supervision – they have a degree and are working toward full licensure.

LCSWs are well-suited for clients who want therapy that may also involve understanding how family, work, or community issues are impacting them. They can diagnose mental health conditions, provide counseling, and advocate for clients’ well-being in a broader social context.

LPC / LMHC / LCMHC – Licensed Professional Counselor (Mental Health Counselor)

Licensed Professional Counselor (LPC) is one of the most common therapy licenses for counselors.

These professionals typically have an M.A., M.S., or M.Ed. in counseling or psychology and then complete several thousand hours of supervised clinical experience post-degree to become licensed.

LPCs are qualified to assess and treat a wide range of mental and emotional issues through counseling. They use techniques like talk therapy, cognitive-behavioral therapy, etc., to help individuals with anything from stress and adjustment issues to diagnosable mental illnesses.

• State variations: 

  • The letters for a licensed counselor vary by state, even though the job role is similar. For example, LMHC stands for Licensed Mental Health Counselor (used in states like New York and Florida), and LCMHC means Licensed Clinical Mental Health Counselor (used in states like North Carolina). Some states use LPCC (Licensed Professional Clinical Counselor) or LCPC (Licensed Clinical Professional Counselor). Despite the different acronyms, all refer to a licensed counselor who has met the education and training standards to practice independently. If you see any of these, you’re essentially looking at a licensed counselor. (For simplicity, we’ll use “LPC” here to encompass all these equivalents.)

LPCs’ education tends to focus on clinical practice and counseling skills (often more so than social work programs). During their training, counselors often accumulate a lot of direct client experience through practicums and internships.

An LPC can treat individuals, couples, or groups for a variety of issues like anxiety, depression, grief, life transitions, and more. They cannot prescribe medication (only an MD or certain nurse practitioners can do that), but they often work in tandem with prescribers if a client needs medication in addition to therapy.

• Associate licenses: 

  • Just like with social workers, counselors often start with an associate license. You might encounter LPC-A, LMHCA, or similar, indicating an Associate Licensed Counselor who is accumulating supervised hours. This is equivalent to what some states call a “licensed graduate counselor” or “intern” – it means they are provisionally licensed and working under supervision for the time being.

LMFT – Licensed Marriage and Family Therapist

Licensed Marriage and Family Therapists (LMFTs) specialize in relationship dynamics. They have at least a master’s degree (often a Master’s in Marriage and Family Therapy or Counseling) plus specialized training in working with couples and families.

After grad school, they complete supervised clinical hours focused on family therapy and then pass a licensing exam to become an LMFT. LMFTs are experts in issues like marital conflict, divorce, parenting challenges, and family communication problems. They look at problems through a family systems lens – understanding how each family member affects the others.

If you’re dealing with challenges that involve your partner or family, an LMFT might be a good fit. They can also do individual therapy, but their training emphasizes relationship issues.

Some states license LMFTs separately from other counselors, and in those places an LMFT may have to document specific experience with couples/families to earn the title.

Not every therapist is trained in family therapy techniques, so seeing “LMFT” after someone’s name assures you that this person has dedicated training in that area.

(Note: Like other licenses, new practitioners may be labeled LMFTA (Associate) when they’re still under supervision.)

LCAS – Licensed Clinical Addiction Specialist (and Other Addiction Counselors)

Therapists with an addiction specialty help people overcome substance use disorders and addictive behaviors. A Licensed Clinical Addiction Specialist (LCAS) is a credential (used for example in North Carolina) for professionals who focus on addiction counseling.

They often have a master’s degree in counseling, social work, or psychology, plus additional training specifically in addiction treatment. To become LCAS, they must complete supervised experience in substance abuse counseling and pass a certification/licensing process.

LCAS professionals work in settings like rehab facilities, outpatient addiction programs, or private practice. They help clients detox (in conjunction with medical professionals), develop coping strategies to avoid relapse, and address the underlying causes of addiction. They create a judgment-free, supportive environment for recovery. Part of their role can include educating clients about triggers, managing cravings, and building a healthy support network.

• Associate level: 

  • Just as with other licenses, you might see LCASA (Licensed Clinical Addiction Specialist Associate) for someone working under supervision in this specialty.

• Other addiction credentials: 

  • Not every state uses the term LCAS. Some use LCDC or LADC (Licensed Chemical Dependency Counselor or Licensed Alcohol and Drug Counselor), or CADC (Certified Alcohol and Drug Counselor) which might be a slightly lower tier or certification-based rather than a full license. The idea is similar: the person has specific expertise in addiction counseling. If you’re seeking help for substance abuse, look for credentials with “Alcohol/Drug Counselor” or “Addiction Specialist” in the title.

Other Specialty Licenses or Roles

There are additional licensed roles you might encounter, depending on the services you seek:

• Licensed Psychological Associate (LPA): 

  • In some states, a person with a master’s in psychology can be licensed to practice in a limited capacity as a Psychological Associate under supervision of a doctoral psychologist. This is less common to see, but if you come across LPA, it means a master’s-level psychologist who can provide certain psychological services, often including testing or therapy, while supervised by a licensed psychologist.

• Psychiatric Nurse Practitioners (PMHNP) and Physician Assistants (PA): 

  • These aren’t “therapist” credentials per se, but you might see letters like PMHNP-BC (Psychiatric-Mental Health Nurse Practitioner, Board Certified) or PA-C (Physician Assistant – Certified) in mental health clinics. These professionals can evaluate and manage mental health medications, similar to psychiatrists. Some also provide therapy if they have training, but typically their role is more medically oriented. If your treatment involves medication management, you might work with one of these in addition to a therapist.

What Does “Associate” or “Intern” Mean in a Therapist’s Title?

Throughout the licenses above, we mentioned “Associate” versions (LCSWA, LCMHCA, etc.). It’s common for mental health professionals to spend a period working under supervision after graduate school before they are fully licensed.

During this time, they often use a modified title: “Associate”, “Intern”, or “Provisional” licensee, depending on the state’s terminology.

For example:

• An LPC-Associate or LPC-Intern has completed a master’s degree and is in the process of completing the required supervised hours to become an LPC.

• An LCSW-A is similarly a social worker under supervision prior to full licensure.

These clinicians can still see clients (and often do the same work as fully licensed counselors), but they have regular supervision meetings with a seasoned licensed professional who oversees their cases.

From a client’s perspective, seeing an “associate” can be perfectly fine – associates have earned their graduate degree and often charge lower fees; they just haven’t finished accumulating experience for independent practice yet.

If you notice your therapist has an "A" or "Intern" in their title, you can always ask how they are supervised and what that means for your care. It usually means you get the benefit of two professionals paying attention to your case (your therapist and their supervisor).

Other Credentials and Certifications to Know (Less Common Letters)

Beyond the standard degrees and licenses, many therapists choose to earn additional certifications to demonstrate expertise in a specialty.

These certifications often add extra letters after their name. Here are a few examples of other credentials you might encounter:

• NCC – National Certified Counselor: This is a national certification for counselors who have met high standards of education and passed a national exam. It’s issued by the National Board for Certified Counselors. An NCC has those letters after their name to indicate they've gone above the basic state requirements. (NBCC also offers specialty certifications like CCMHC for clinical mental health, etc.) While respected, note that NCC is voluntary – it’s not a license, so it doesn’t by itself allow someone to practice. It’s more like an extra credential showing professionalism.

• CRC – Certified Rehabilitation Counselor: A certification for counselors who specialize in rehabilitation counseling (helping people with disabilities achieve their personal, career, and independent living goals through counseling). If a therapist works in vocational rehabilitation or disability services, you might see CRC after their name. For example, Emily Decker, MS, CRC, LPC indicates she is a rehab counselor in addition to being a licensed professional counselor.

• CADC – Certified Alcohol and Drug Counselor: This is a credential for addiction counselors. A CADC (or variations like CADC-I, CADC-II, which may denote different levels) typically has specific training in substance abuse counseling. In some cases, a professional might obtain a CADC certification if they do not have a master’s (some CADC levels require only a certain amount of training and supervision). A licensed clinician like an LCAS might also hold a CADC as an additional qualification. Essentially, seeing CADC tells you that person is focused on addiction recovery work.

• ATR-BC / ATR – Registered Art Therapist (Board Certified): Art therapists use creative techniques to help clients express themselves and heal. They often earn a master’s in art therapy and then the ATR credential (granted by the Art Therapy Credentials Board). ATR-BC means the art therapist is board-certified. These letters would appear if you’re seeing someone who practices art therapy as a modality. Similarly, there are credentials for music therapists (MT-BC for Board Certified Music Therapist) and play therapists (RPT for Registered Play Therapist), etc. These indicate a specialization in a particular therapeutic approach.

• Life Coach Certifications (e.g. CPC): Coaching is not the same as therapy, but many life coaches advertise credentials too. One common certification is CPC – Certified Professional Coach, awarded by coaching training organizations (for example, iPEC Coaching offers a CPC program). A CPC is not a licensed therapist; it signifies the person has completed training in life coaching techniques. Coaches focus on goals, motivation, and personal development, rather than treating mental health conditions. Coaching certifications (such as ACC, PCC, MCC from the International Coach Federation) indicate levels of coaching experience. If you see a coach with letters after their name, remember those are coaching credentials, not mental health licenses. Coaches can be great for career or personal goal guidance, but they do not treat clinical issues like depression or anxiety in the way therapists do.[2]

Keep in mind: There are many other letters you might stumble across.

For example, RPT-S (Registered Play Therapist – Supervisor), CSAT (Certified Sex Addiction Therapist), EMDR-C (EMDR Certified therapist, for trauma therapy), and so on.

Professionals often list certifications to signal they’ve done extra training in a modality or have a niche expertise. If you see a credential you don’t recognize, don’t hesitate to ask the therapist.

Choosing the Right Therapist in North CarolinaThe alphabet soup can be overwhelming, but remember:

• LCMHC, LCSW, LMFT, LCAS, Psy.D., and Ph.D. psychologists can all provide therapy.

• Psychiatrists (M.D./D.O.) and PMHNPs can prescribe medications.

• Specialized certifications (EMDR-C, ATR-BC, CSAT) show niche expertise.

• Coaches (CPC) are not clinical therapists, but may help with life goals.

What matters most? Finding a therapist you feel safe and comfortable with. Credentials ensure training, but the therapeutic relationship is what drives healing.

At Morrisville Counseling and Consulting, our licensed team serves clients across Morrisville, Cary, Raleigh, Durham, Apex, and the Triangle.

If you’re not sure what type of therapist you need, we can help you decide.

Schedule a free 15-minute consultation today! Reach out to our professional team at Morrisville Counseling and Consulting or send us a message and we can chat over a free consultation to find our more about you and guide you in the right direction.

References

1. Therapist Titles, or “What Do Those Letters After Your Name Mean?" - Emily Decker - https://medium.com/@emily.jean.decker/therapist-titles-or-what-do-those-letters-after-your-name-mean-c109a0218ea\

2. Types of Coaching Certifications (Definitions & Differences) - iPEC - https://www.ipeccoaching.com/blog/3-types-of-coaching-certifications-definitions-differences#