The LMHC exam is the NCMHCE — the National Clinical Mental Health Counseling Examination. Licensed Mental Health Counselor is a licence title, not a separate exam: Florida’s board states that applicants must pass the NCMHCE, administered by the National Board for Certified Counselors, and directs a $350 registration fee to the CCE for a first attempt and $275 for a re-exam. Other boards use the titles LPC or LPCC for the same role, and most require the same exam. The 10 questions below come from the case-based format the NCMHCE actually uses.
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Yes. LMHC — Licensed Mental Health Counselor — is the licence, not the exam. Florida’s Board of Clinical Social Work, Marriage & Family Therapy and Mental Health Counseling states that applicants "must pass the National Clinical Mental Health Counseling Examination (NCMHCE) administered by the National Board for Certified Counselors (NBCC)."
What does the LMHC exam cost?
Florida’s board directs applicants to "send the registration fee of $350 directly to the Center for Credentialing & Education (CCE) for initial exam and $275 for re-exam." Fees are set per state board, so confirm the amount with yours before paying.
What degree do I need before I can sit it?
Florida requires an official transcript showing "the minimum award of a master’s degree from an institutionally accredited program — at least 60 semester hours or 80 quarter hours." Requirements vary by board; check yours.
Do all states call the licence LMHC?
No. Boards in states such as Florida, Massachusetts and New York use Licensed Mental Health Counselor, while others license the same role as LPC or LPCC. The national exam most of them require is the NCMHCE either way.
Is passing the exam enough to get licensed?
No. It is one requirement among several. Florida also requires a Board-approved 8-hour Laws and Rules course and a 3-hour HIV/AIDS course, on top of the degree and supervised experience its rules set out.
Test yourself: 3 NCMHCE practice questions
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Question 1
Eleanor feels guilty for enjoying time with her grandchildren, 'like I'm betraying George,' and she frames the whole struggle through her Catholic faith. How do you best work with her spiritual and values framework here?
▸ Why A is the answer
Her faith is not a side issue; it is the framework she is using to understand her grief, and it can be a powerful resource. Exploring what her beliefs say about enduring love and about maintaining a bond with George helps her discover that honoring him and living her own life are not opposites. That kind of meaning-making, drawn from her own values, is exactly what loosens the guilt and lets her move forward while staying connected to him.
Question 2
Midway through the session Eleanor falls silent, her eyes fill with tears, and she whispers, 'I just miss him so much.' Which response best reflects empathic attunement?
▸ Why C is the answer
Attunement means meeting her where she is. Staying with her in the silence and then softly reflecting how deeply she misses George lets her feel accompanied in the feeling rather than rushed out of it. In a raw grief moment, being present with her is the intervention; it communicates that her pain can be borne alongside her.
Question 3
Eleanor's 'fog' has not lifted, and last week she got lost driving to Karen's house on a route she has driven for fifteen years. What is the most appropriate ongoing assessment step regarding her cognitive symptoms?
▸ Why D is the answer
Getting lost on a route she has driven for fifteen years is a red flag that deserves a proportionate, structured response. A brief validated cognitive screen plus a timeline of when the changes began, followed by coordinating a medical evaluation, gathers the right information without overreacting. It keeps open the real possibilities, grief and depression, medical or medication effects, or an emerging neurocognitive disorder, rather than assuming one.
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