LCADC (OUT OF STATE) Licensed Clinical Alcohol and Drug Counselor

LCADC (OUT OF STATE)

Licensed Clinical Alcohol and Drug Counselor

APPLICATION INSTRUCTIONS

LICENSED CLINICAL ALCOHOL AND DRUG COUNSELLOR - OUT OF STATE

All forms must be legible, complete, signed, and dated (where applicable) or processing may be delayed.
Download and Complete the LCADC (Out of State) Application
Include a payment receipt with your application.
LCADC (Out of State) Application Fee: $250.
PAY HERE: https://mdbnc.health.maryland.gov/pct_pay/Pay_Fee_27.aspx
Fees are non-refundable and non-transferable.

Name*

Email*

Phone*

Phone

Out of State Verification*

Select Your Home State

NEEDED

LCADC (Out-of-State) Application Packet Checklist

Download and Complete the LCADC (Out of State) Application

LCADC (Out of State) Application Fee: $250

PAY HERE:

https://mdbnc.health.maryland.gov/pct_pay/Pay_Fee_27.aspx

The following are the application requirements. All forms must be legible, complete, signed, and dated (where applicable) or processing may be delayed.

Completed Application, Signed & Notarized
LCDAC (Out of State) Application Payment Receipt
2 x 2 Photograph (Passport sized)
Copy of Official Transcript
Master of Addiction Counselor Board Exam (MAC)
Copy of MLA Certificate of Completion
Criminal History background Check

File Upload*

Please upload your Completed Application, Payment Receipt and Supporting Document Here.

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