How to find an addiction therapist or substance use counselor in Texas

If you need help now: call 911 in an emergency. In a mental health or substance use crisis, call or text 988, any time. SAMHSA's National Helpline, 1-800-662-4357, is free, confidential and open 24/7 for treatment referrals. Stopping heavy drinking suddenly can be dangerous; see alcohol detox in Texas first.

Who to look for

If you need	Look for
Counseling for drinking or drug use	An LCDC, or an LPC, LCSW, LMFT or psychologist who treats substance use
Help with substance use and depression, anxiety, PTSD or another mental health condition	A clinician licensed for mental health who also treats substance use (many hold an LCDC as well), or a program that treats both: see dual diagnosis treatment in Texas
Medication for alcohol or opioid use disorder	A physician, physician assistant or nurse practitioner who prescribes it, alongside your counselor
More than one or two sessions a week	A licensed program: intensive outpatient (IOP) or partial hospitalization (PHP). See outpatient rehab in Texas.
To stop heavy daily drinking, or opioids	Medical care first: a doctor or a detox program, then counseling

Our guide to choosing a therapist in Texas explains each license's training and the general first-call questions. This guide covers what's different when the problem is alcohol or drugs.

LCDC vs LPC, LCSW, LMFT and psychologist: who can do what

What matters for substance use is the scope of each license, set by Texas law and rules:

Credential	Substance use counseling	Mental health treatment	Licensed by
LCDC Licensed Chemical Dependency Counselor	Yes: it's the Texas license to counsel people with substance use disorders (Occupations Code chapter 504)	No. The rules say an LCDC isn't qualified to treat mental health disorders, and that their services address substance use and its impact (26 TAC 562.3)	Texas Health and Human Services Commission (HHSC)
Counselor intern often written CI or LCDC-I	Yes, under supervision, while completing 4,000 hours of supervised work toward the LCDC	No	Registered with HHSC
LPC, LCSW or LMFT	Yes, within their license. In a licensed treatment program, they count as qualified credentialed counselors for substance use only with at least 1,000 hours of documented substance use treatment experience (26 TAC 564.1)	Yes	Behavioral Health Executive Council (BHEC)
Psychologist	Yes, within their license; the same 1,000-hour rule applies in a licensed program	Yes, including psychological testing	BHEC
Psychiatric nurse practitioner	Evaluation and medication, including for addiction	Yes: diagnoses and prescribes under a prescriptive authority agreement with a physician	Texas Board of Nursing
Psychiatrist or other physician	Diagnosis and medication; some are board-certified in addiction medicine or addiction psychiatry	Yes	Texas Medical Board

• The LCDC's training is all about substance use. The path takes 270 classroom hours of chemical dependency education, a 300-hour practicum (unless a related bachelor's degree exempts you), 4,000 hours of supervised work as a counselor intern, a written exam and at least an associate degree (26 TAC chapter 562).
• Many counselors hold two licenses, such as LPC and LCDC. One clinician can then work on the drinking and the depression in the same plan.
• An LCDC's family sessions are about the substance use. HHSC says an LCDC isn't qualified to give family counseling for problems that don't involve substance use. For couples or family therapy beyond that, look for an LMFT or another mental health licensee. Family members can also get support of their own: see Al-Anon, Nar-Anon and family support in Texas.

Who prescribes medication for addiction

Counselors, social workers, marriage and family therapists, LCDCs and psychologists don't prescribe in Texas. For medication, you need a physician, a physician assistant (under a physician's delegation) or a nurse practitioner (under a prescriptive authority agreement). It can be your primary care doctor.

Medication	For	Who can prescribe or give it
Naltrexone, acamprosate, disulfiram	Alcohol use disorder	FDA-approved and not addictive; NIAAA says a primary care doctor can prescribe them. Naltrexone also comes as a monthly shot.
Buprenorphine (for example, Suboxone)	Opioid use disorder	Since the MAT Act, any clinician whose DEA registration covers Schedule III drugs, where state law allows. See how to get Suboxone in Texas.
Methadone	Opioid use disorder	Only at opioid treatment programs certified by SAMHSA. See methadone clinics in Texas.

Ask your counselor how they work with your prescriber. With your written consent, the two can share what each needs to know.

A counselor's office or a licensed program?

Texas requires an HHSC chemical dependency treatment facility license to offer chemical dependency treatment, but it exempts a person who personally counsels people and doesn't offer a treatment program, and a licensed practitioner's own office (Health and Safety Code chapter 464, sections 464.002 and 464.003). In practice:

• Weekly sessions with one counselor, in an office or by video, can be a private practice.
• A structured program (outpatient groups you enroll in, IOP, PHP, residential or detox) needs the facility license. You can look a program up on HHSC's chemical dependency treatment facilities page.
• With Texas Medicaid, substance use treatment, outpatient or residential, may be delivered only in a licensed chemical dependency treatment facility (TMHP notice). So a Medicaid member usually sees an addiction counselor through a licensed program.

How to check a license

It's free and takes a minute. Look for an active status, a matching name and any board orders. If you want a fully licensed counselor, look for LCDC, not counselor intern.

If they're a...	Check with
LCDC or counselor intern	HHSC's online license search, linked from its LCDC program page
LPC, LCSW, LMFT, psychologist or an associate	"Verify a License" at bhec.texas.gov. For an associate, look up the supervisor too.
Nurse practitioner	Texas Board of Nursing license verification, which shows prescriptive authority
Physician or physician assistant	Texas Medical Board Look Up a License

Cima Find Care shows when a listed counselor's license matched a Texas roster, and the date it was checked (how listings work). Your own check is still worth the minute.

Where to find an addiction therapist in Texas

• Cima Find Care's lists by city, with phone numbers, from the federal NPI registry: addiction counselors in Houston, Dallas, San Antonio, Austin, Fort Worth and El Paso; addiction physicians in Houston, Dallas and San Antonio; and addiction psychologists in Houston and Dallas. Other cities are on the Texas page.
• Your health plan. Call the number on your card and ask for in-network clinicians who treat substance use, of any license, and who are taking new clients.
• For alcohol, NIAAA's Alcohol Treatment Navigator, a free federal guide to finding alcohol treatment from therapists, doctors and programs.
• For programs, SAMHSA's FindTreatment.gov.
• No insurance? Texas pays for treatment for people who qualify: call 2-1-1 and ask for your region's OSAR. See free and state-funded rehab in Texas.
• Veterans can get substance use care through VA health care, and sometimes through VA Community Care: see addiction treatment for veterans in Texas.

Not sure whether you need a counselor or a program? Answer four quick questions.

Questions to ask an addiction therapist on the first call

1. Which license do you hold, and is substance use a main part of your work? If you're an intern or associate, who's your supervisor?
2. If I also have anxiety, depression or trauma, can you treat that too? If they hold only an LCDC, the answer is no, so ask who they work with.
3. Which approaches do you use? NIDA's research principles name behavioral therapies with evidence behind them, including cognitive behavioral therapy, contingency management, motivational enhancement therapy, the community reinforcement approach and family behavior therapy.
4. How do you feel about medication for addiction? SAMHSA's guide to finding quality treatment lists FDA-approved medication among the signs of good care. If you take one, or might, make sure the counselor is comfortable working alongside it.
5. How would you involve my family, with my consent?
6. What happens if I drink or use between sessions, and when would you suggest more support, such as an IOP?
7. How do you protect my records? Records from federally assisted substance use programs have extra federal protection: in most cases they can't be shared without your written consent (42 CFR Part 2).
8. Do you take my insurance, and what will a session cost me? If you'll pay yourself, ask for a Good Faith Estimate.
9. Do you see clients by video? The clinician must be licensed in Texas when you're in Texas during the session.

Need an assessment for a court, probation or an employer? Ask the person who requires it whether they accept this clinician's assessment, and what the report has to include, before you book.

Using insurance for an addiction therapist

• Commercial plans differ. Some credential LCDCs for substance use services; many credential only master's-level licenses (LPC, LCSW, LMFT, psychologist) for therapy. Ask your plan which in-network clinicians treat substance use, and whether a licensed outpatient program is an option.
• Medicare has paid licensed mental health counselors and marriage and family therapists since January 1, 2024 (CMS). It doesn't enroll the LCDC license on its own; an addiction counselor can enroll as a mental health counselor only by meeting every requirement, including a master's degree and two years or 3,000 hours of supervised experience after it (42 CFR 410.54).
• Texas Medicaid pays for substance use counseling through licensed treatment programs in your health plan's network, with no copays. See rehab that takes Medicaid in Texas.
• Paying yourself? Ask about a sliding fee. You have a right to a written Good Faith Estimate before care; our Good Faith Estimate tool shows what one includes.

Federal and Texas parity laws keep a plan's limits on substance use care in line with medical care. More in how to use your insurance for therapy in Texas and how much therapy costs in Texas.

When weekly counseling isn't enough

Talk to your counselor about more support if you're drinking or using more, missing work or school, or have had to go to an emergency room. An intensive outpatient program gives adults at least 9 hours of treatment a week, and a partial hospitalization program at least 20, while you live at home; residential treatment means living at the program. Inpatient vs outpatient rehab explains who needs which. If you're thinking about suicide, don't wait for the next session: call or text 988.