Therapy in North Dakota: Costs, Licensing & How to Find Help
A guide to therapy in North Dakota — costs, licensing, telehealth rules, and how to find a therapist.
$140
Avg. session cost
#24
MH ranking (of 51)
260
Providers per 100K
7.5%
Uninsured rate
Therapist Licensing Requirements
Overseen by the North Dakota Board of Counselor Examiners.
| Credential | Title | Supervised Hours | Required Exams |
|---|---|---|---|
| LPCC | Licensed Professional Clinical Counselor | 2,000 | NCE, NCMHCE |
| LCSW | Licensed Clinical Social Worker | 3,000 | ASWB Clinical |
| LMFT | Licensed Marriage and Family Therapist | 2,000 | MFT National Exam |
| Licensed Psychologist | Licensed Psychologist | 4,000 | EPPP |
Therapy Costs in North Dakota
The average therapy session in North Dakota costs $140 — $35 below the national average of $175. Online therapy is typically 20% less.
| Metro Area | Average | Range |
|---|---|---|
| Fargo | $145 | $110–$185 |
| Bismarck | $135 | $100–$175 |
Telehealth Rules in North Dakota
PSYPACT Member (since 2021)
PSYPACT member state. Out-of-state psychologists may use APIT credentials. Other providers must hold a North Dakota license.
Audio-only therapy: Allowed
Medicaid telemental health: Covered
Consent: Informed consent required; verbal consent acceptable when documented in the medical record.
Insurance & Parity in North Dakota
Parity enforcement: moderate
Medicaid expanded: Yes (no session cap)
Typical in-network copay: $25–$50
Major insurers: Blue Cross Blue Shield of North Dakota, Sanford Health Plan, Medica
Crisis Resources in North Dakota
North Dakota Department of Health and Human Services — Behavioral Health Division
Notable Programs
- North Dakota's Human Service Centers provide community-based behavioral health services across eight regions.
- The ND Behavioral Health Division funds crisis stabilization beds and mobile crisis teams in rural areas.
- North Dakota's Free Through Recovery program provides peer support and community-based behavioral health services as an alternative to incarceration.
Therapy Landscape in North Dakota
North Dakota's low population density and harsh winters create distinct challenges for mental health access. Fargo, Bismarck, and Grand Forks have the most providers, while western oil-country communities and tribal reservation areas are significantly underserved. The state's oil boom brought rapid population growth and associated stressors — substance use, family disruption, and isolation — that increased demand for behavioral health services. North Dakota has a network of human service centers that provide community-based mental health care across eight regions. Out-of-pocket therapy costs typically range from $95 to $160 per session. Blue Cross Blue Shield of North Dakota and Sanford Health Plan are the major insurers. North Dakota Medicaid covers outpatient behavioral health services.
Finding a Therapist in North Dakota
North Dakota licenses professional clinical counselors (LPCCs), clinical social workers (LCSWs), psychologists, and marriage and family therapists (LMFTs). The North Dakota Board of Counselor Examiners oversees counselor licensing. The state participates in PSYPACT and the Counseling Compact, significantly expanding telehealth options for residents in remote areas. This is especially important given that some North Dakota counties have zero resident mental health professionals.
Cognitive behavioral therapy (CBT) is the most commonly practiced evidence-based therapy in North Dakota for anxiety and depression. For substance use concerns, motivational interviewing and integrated treatment are available through human service centers.
Without insurance, sessions typically cost $95 to $160. Insurance copays range from $20 to $40. Human service centers provide reduced-cost or free services based on income.
Yes. North Dakota Medicaid covers outpatient mental health services including individual therapy, group therapy, crisis services, and substance use treatment.
Telehealth is the most practical option for residents in the western part of the state. North Dakota's participation in PSYPACT and the Counseling Compact expands your virtual options. Regional human service centers also serve these areas.
Yes. Providers in western North Dakota are familiar with the unique stressors of the oil industry and agricultural life, including isolation, shift work, and family disruption. Ask about this specialty during consultations.
Look for LPCC, LCSW, licensed psychologist, or LMFT. All are regulated by North Dakota licensing boards and require graduate education and supervised clinical hours.
North Dakota's human service center network and growing telehealth infrastructure are helping close gaps in mental health access. If you are unsure where to start, your regional human service center can provide an assessment and connect you with appropriate care.