Licensure Exams
The LMHC exam: what you'll actually take
Last updated September 29, 2026 · Published by Counseling Exam Assist
Short answer
For most states that issue the LMHC (Licensed Mental Health Counselor), the licensure exam is the NCMHCE — 11 clinical case simulations from NBCC. Some states add a laws and rules exam or accept the NCE. Confirm with your state board before registering.
LMHC exam by state
| State | Exam |
|---|---|
| Florida | NCMHCE + Florida Laws & Rules — details |
| New York | NCMHCE — details |
| Washington | NCMHCE or NCE — details |
| Massachusetts | NCMHCE |
What the NCMHCE tests
- Professional practice and ethics
- Intake, assessment, and diagnosis (DSM-5-TR)
- Core counseling attributes
- Treatment planning
- Counseling skills and interventions
Start with a free NCMHCE practice case, then read how to pass the NCMHCE. Using the LPC title? See the LPC exam guide.
Frequently asked questions
What exam do you take to become an LMHC?
Most states that issue the LMHC (Licensed Mental Health Counselor) title — including Florida, New York, Massachusetts, and Washington — use the NCMHCE, NBCC's clinical case simulation exam. Some states also accept the NCE or add a state laws and rules exam.
Is the LMHC exam the same as the NCMHCE?
In most LMHC states, yes. The NCMHCE is the licensure exam for clinical mental health counseling. Always confirm with your state board, since a few accept the NCE instead or in addition.
What is the difference between an LMHC and an LPC?
They are different state titles for similar professional counselor licenses. LMHC is used in states like Florida and New York; LPC is used in states like Texas and Pennsylvania. Exam requirements depend on the state, not the title.
How hard is the LMHC exam?
We did not locate verified national first-time or retake pass rates in the official NBCC/CCE materials reviewed. State and program statistics are not national rates.
Practice until the dashboard says you're ready
$100 one-time for unlimited AI-generated NCMHCE cases and NCE practice. If our dashboard says you're Exam Ready and you don't pass, email annie@emdrassist.com with your Exam Ready screenshot and failed score (with dates) for a full refund.
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