Part 2 - The Legal Shield & How to Protect Your Care

Feb 27

That Facebook post I mentioned last week? By using the DOH search tool, I was able to confirm that the provider wasn't just 'working from home'. They were operating outside the legal protections Washington state has built for you. Your mental health is worth the 30 seconds it takes to check. Read until the end or scroll down to learn how to do that for yourself. If you are a provider, read until the end to know how I handled this situation. If you don't know me: Hi there! I’m Anne, a LMHCA in private practice in Kirkland, WA who loves working with neurospicy people who are ready to make peace with food and their body.

In Washington, practicing therapy without a license isn't just a professional faux pas: it’s a violation of state law. Under the Revised Code of Washington (RCW), the state maintains a "practice act," which means the actual activity of providing mental health therapy is legally restricted to those with the proper credentials.

Here’s why it is legally and practically impossible (and dangerous) for someone to practice therapy in Washington without a valid license.

1. It is a Criminal Offense

According to RCW 18.130.190, "unlicensed practice" of a health profession is a crime.

First Violation: Classified as a gross misdemeanor.
Subsequent Violations: Can be escalated to a Class C Felony. The state Department of Health (DOH) has the authority to investigate unlicensed individuals, issue "Cease and Desist" orders, and impose civil fines of up to $1,000 per day of unauthorized practice.

2. Title Protection vs. Practice Protection

Some states only protect the title (e.g., you can’t call yourself a "Licensed Counselor"). However, Washington also protects the scope of practice.

Under RCW 18.225, the state defines "Mental Health Counseling," "Marriage and Family Therapy," and "Social Work" as specific clinical acts.
If a person is treating a mental disorder, using clinical techniques to change behavior, or "holding themselves out" as providing these services for a fee, they are practicing therapy. Doing this without a license is a direct violation of the law.

3. The "State Border" Rule (Telehealth)

A common misconception is that a therapist licensed in California can see a client in Seattle via Zoom. This is illegal. * In Washington, the "practice" of therapy occurs where the client is located.

If the client is in Washington, the therapist must be licensed by the Washington DOH (or have a specific, temporary "reciprocity" or "probationary" license).
This ensures that the Washington DOH has the power to protect you, the local resident. They cannot easily discipline or subpoena an out-of-state "coach" if something goes wrong.

4. Mandatory Reporting & Public Safety

Licensed therapists are Mandatory Reporters under RCW 26.44. This means they are legally required to report child abuse, neglect, or the abuse of vulnerable adults.

Unlicensed "consultants" or "guides" often operate outside this legal framework.
Without a license, there is no state-mandated background check, no verification of education, and no legal requirement to report situations that could save a life.

5. Lack of Malpractice Insurance

Professional liability insurance providers typically will not cover someone practicing a regulated profession without a license.

If an unlicensed person causes emotional or psychological harm through "treatment," they likely have no insurance to cover the damages.
For the client, this means no financial protection and no professional body to advocate for them in a dispute.

If a foreign therapist wants to practice in Washington, they must essentially "re-qualify" by proving their education and experience meet Washington's specific legal benchmarks.

6. The "Equivalency" Barrier for foreign therapists

Circling back to the Facebook posts from the foreign therapist, I did some research on what that means here in Washington. I believe in the importance of researching to make sure we are respecting the laws or regulations. In my country of origin therapy is not as regulated as it is here in the United States. Anyone can call themselves a “therapist” in France so a part of me (Hello Internal Family System) can understand why this person assumed it was ok to advertise their services in a local Facebook group for expatriates.

The biggest hurdle for foreign therapists is the Educational Equivalency Review. Washington law requires that a therapist’s degree be "substantially equivalent" to a U.S. Master’s or Doctorate.

Transcript Evaluation: The therapist must hire a third-party agency (like NACES or a similar board-approved service) to perform a course-by-course audit.
Credit Gap: Often, foreign degrees have different credit structures. If the DOH finds the therapist is missing a specific "Washington required" subject (like Child Abuse Reporting or Adolescent Development), the therapist must go back to school for those specific credits before they can even apply.

7. No International Reciprocity

While Washington has a "Probationary License" for therapists moving from other U.S. states, this does not apply to other countries.

There is no international treaty or "compact" that allows a therapist from another country to bypass Washington’s licensing requirements.
Every foreign applicant is treated as a "License by Examination" applicant, meaning they usually have to take and pass the National Board Exams (like the NCMHCE) in English, regardless of their experience level.

Why this protects Washington residents

It might seem bureaucratic, but these rules protect the public in three ways:

Legal Compatibility: It ensures the therapist understands Washington-specific laws (like "Duty to Warn" and mandatory reporting), which may differ wildly from their home country.
Cultural Competency: It requires them to demonstrate an understanding of the diverse social and cultural landscape in the U.S.
Vetting: It prevents someone who lost their license for misconduct in another country from "starting fresh" in Washington without a background check.

I felt a strong pull to take action regarding the unlicensed advertising I saw online. With the support of my supervisor, who virtually 'held my hand' through the process, I filed a formal complaint with the DOH. I didn't do it anonymously as I wish to receive updates on the matter and it is only possible if sharing your details. It wasn't about being punitive; it was about honoring the path we clinicians take. We go through rigorous exams and years of supervision for one reason: to ensure that when a client sits across from us, they are safe. The DOH exists to guard that safety. I’m still waiting for an update on the case, and I’ll be sure to share what I learn about how these protections work in practice.

Check out the Department of Health (DOH) Provider Credential Search.

This tool is free, public, and provides "primary source verification," meaning it’s the exact same data the state uses for legal and official purposes.

Here is a quick guide on how to use it and what to look for.

Step 1: Access the Tool

Go to the official Washington Department of Health Provider Credential Search.

Step 2: Enter the Search Criteria

You don't need a license number to find someone. You can search by:

Last Name and First Name: Be sure to use their full legal name (nicknames won't show up).
Credential Type: If you want to narrow it down, you can select "Licensed Mental Health Counselor" or "Licensed Social Worker" from the dropdown, but searching by name alone is usually faster.

Step 3: Interpret the Results

Once you find the therapist, click on their name or credential number to see their full profile. Look for these four critical fields:

Status: * Active: The therapist is currently authorized to practice.

Expired: They cannot legally practice until they renew.
Suspended/Revoked: They have been legally barred from practicing due to misconduct.

Credential Type: * Confirm it matches what they told you (e.g., LMHC for Counselor, LICSW for Social Worker).

If you see "Associate" (e.g., LMHCA), they must be working under a supervisor like myself. Shout out to all the amazing supervisors, especially mine!

Expiration Date: Verify that the date hasn't passed.
Enforcement Action: * If this says "Yes," there is a disciplinary record.

Pro Tip: You can actually click the "Yes" to view the legal documents describing exactly what happened (e.g., an ethics violation or a record-keeping error).

Why this is a "Must-Do" for you

Safety Check: It ensures the therapist hasn't had their license taken away in another county or under a different business name.
Credential Fraud: It protects you from "imposter" therapists who use professional-sounding titles without having the actual degree or state approval.
Accountability: If their name isn't in this database, the State of Washington has no power to help you if they harm you or behave unethically.

Tip: it is the same for other healthcare professions! Don't hesitate to check on the DOH website!

Disclaimer: The information provided in this post is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult with a qualified healthcare professional regarding your specific health needs.