Couples Therapy in America: Analysis of 34,963 Therapists Across All 50 States (2026)

How accessible is couples therapy in America? To find out, we analyzed 34,963 therapist profiles from the National Provider Identifier Registry — the most comprehensive public database of licensed healthcare providers in the United States. The results reveal significant disparities in access across states, surprising regional patterns in therapist credentials, and a handful of cities that serve as major hubs for couples therapy.

This is, to our knowledge, the most detailed public analysis of couples therapy access by state ever published. Whether you are a journalist covering mental health access, a researcher studying the therapy workforce, or someone trying to understand the landscape before finding a therapist, this data tells a compelling story.

Key Findings

• We identified 34,963 licensed couples and family therapists across all 50 states and Washington, D.C., using data from the National Provider Identifier (NPI) Registry.
• California leads the nation with 1,536 therapists, followed by Minnesota (1,232) and Washington (1,196).
• Per capita, Hawaii has the highest therapist density at 45.56 per 100,000 residents — 19.5x higher than West Virginia (2.34 per 100K), which ranks last.
• LMFT (Licensed Marriage and Family Therapist) is the most common credential nationally, accounting for 39.2% of all therapists, and is the dominant credential in 50 of 51 states.
• Las Vegas, Nevada is the single city with the most couples therapists (575), followed by Chicago, Illinois (435) and Louisville, Kentucky (432).
• The median state (Ohio) has just 796 therapists, highlighting how heavily concentrated the profession is in a handful of large states.

Couples Therapists by State

The following table ranks every state (plus Washington, D.C.) by the total number of licensed couples and family therapists registered in the NPI database. Click any state to browse therapists in that state.

Rank	State	Therapist Count	Top City	Most Common Credential
1	California	1,536	Los Angeles	LMFT
2	Minnesota	1,232	Minneapolis	LMFT
3	Washington	1,196	Seattle	LMFT
4	Florida	1,185	Miami	LMFT
5	Texas	1,185	Houston	LMFT
6	North Carolina	1,181	Charlotte	LMFT
7	Connecticut	1,180	West Hartford	LMFT
8	Pennsylvania	1,169	Philadelphia	LMFT
9	Kansas	1,160	Wichita	LMFT
10	Colorado	1,158	Denver	LMFT
11	Utah	1,158	Provo	LMFT
12	Illinois	1,150	Chicago	LMFT
13	New York	1,150	New York	LMFT
14	Nevada	1,145	Las Vegas	LMFT
15	Tennessee	1,143	Nashville	LMFT
16	Oregon	1,136	Portland	LMFT
17	Wisconsin	1,126	Madison	LMFT
18	Georgia	1,112	Atlanta	LMFT
19	New Jersey	1,006	Montclair	LMFT
20	Indiana	978	Indianapolis	LMFT
21	Virginia	883	Fairfax	LMFT
22	Massachusetts	850	Boston	LMFT
23	Kentucky	833	Louisville	LMFT
24	Arizona	822	Phoenix	LMFT
25	Oklahoma	798	Oklahoma City	LMFT
26	Ohio	796	Columbus	LMFT
27	Michigan	702	Grand Rapids	LMFT
28	Hawaii	663	Honolulu	LMFT
29	Louisiana	563	Shreveport	LMFT
30	Maryland	495	Silver Spring	LMFT
31	South Carolina	494	Spartanburg	LMFT
32	Iowa	461	Cedar Rapids	LMFT
33	Missouri	420	Kansas City	LMFT
34	New Mexico	417	Albuquerque	LMFT
35	Alabama	368	Birmingham	LMFT
36	Idaho	361	Boise	LMFT
37	Mississippi	229	Jackson	LMFT
38	New Hampshire	192	Concord	LMFT
39	Arkansas	180	Little Rock	LMFT
40	Rhode Island	169	Providence	LMFT
41	Nebraska	139	Lincoln	LPC
42	Maine	119	Portland	LMFT
43	Alaska	109	Anchorage	LMFT
44	Montana	106	Bozeman	LMFT
45	South Dakota	99	Sioux Falls	LMFT
46	Wyoming	92	Cheyenne	LMFT
47	Vermont	86	Brattleboro	LMFT
48	District of Columbia	77	Washington	LMFT
49	Delaware	70	Wilmington	LMFT
50	North Dakota	51	Fargo	LMFT
51	West Virginia	42	Morgantown	LMFT

Therapist Density: Per-Capita Analysis

Raw therapist counts tell only part of the story. A state with thousands of therapists may still leave residents underserved if the population is large. To get a clearer picture, we calculated the number of therapists per 100,000 residents using 2024 Census population estimates. The national average across all states is 14.29 therapists per 100K.

Top 10 States by Therapist Density

Rank	State	Therapists	Population	Per 100K
1	Hawaii	663	1,455,271	45.56
2	Kansas	1,160	2,937,880	39.48
3	Nevada	1,145	3,104,614	36.88
4	Utah	1,158	3,271,616	35.4
5	Connecticut	1,180	3,605,944	32.72
6	Oregon	1,136	4,237,256	26.81
7	Minnesota	1,232	5,706,494	21.59
8	Oklahoma	798	3,959,353	20.15
9	Colorado	1,158	5,773,714	20.06
10	New Mexico	417	2,117,522	19.69

Bottom 10 States by Therapist Density

Rank	State	Therapists	Population	Per 100K
42	West Virginia	42	1,793,716	2.34
43	California	1,536	39,538,223	3.88
44	Texas	1,185	29,145,505	4.07
45	Florida	1,185	21,538,187	5.5
46	New York	1,150	20,201,249	5.69
47	Arkansas	180	3,011,524	5.98
48	North Dakota	51	779,094	6.55
49	Ohio	796	11,799,448	6.75
50	Missouri	420	6,154,913	6.82
51	Michigan	702	10,077,331	6.97

The gap between the best- and worst-served states is striking. Residents of Hawaii have access to 45.56 therapists per 100K people, while those in West Virginia have just 2.34. That means a resident of Hawaii is roughly 19.5x more likely to have a couples therapist nearby than someone in West Virginia.

Most Common Credentials

Couples and family therapists hold a variety of licenses depending on their training and the state where they practice. We grouped the 129 distinct credential strings in our dataset into five categories:

• LMFT — Licensed Marriage and Family Therapist (includes MFT, AMFT, LAMFT, LCMFT, and similar variants)
• LPC — Licensed Professional Counselor (includes LMHC, LCPC, LPCC, and similar variants)
• LCSW — Licensed Clinical Social Worker (includes LICSW, LISW, LMSW, MSW variants)
• Psychologist — Doctoral-level providers (Ph.D., Psy.D., D.Min.)
• Other — Credentials that do not fall neatly into the above (M.A., M.S., etc.)

Credential Category	Count	Percentage
LMFT	13,716	39.2%
Other	1,397	4.0%
Psychologist	708	2.0%
LPC	377	1.1%
LCSW	264	0.8%

The LMFT credential dominates nationally at 39.2%, which is unsurprising given that marriage and family therapy is the core training focus for this license. Other comes in second at 4.0%. The "Other" category largely consists of therapists who listed degree abbreviations (M.A., M.S.) rather than their license type in the NPI Registry. For more on what these credentials mean and how to choose between them, see our guide to understanding therapist credentials.

States Where Each Credential Dominates

Licensing laws and training traditions vary by state, creating interesting regional patterns in which credential is most common. Here is a breakdown of the dominant credential type in each state:

LMFT (50 states)

Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming

LPC (1 states)

Nebraska

The geographic patterns are noteworthy. LMFT dominance is widespread, reflecting the fact that marriage and family therapy programs specifically train therapists for couples work. States where LPC or LCSW credentials are more common often have different licensing structures or stronger social work traditions. For a deeper dive into what these credentials mean in practice, see our credential guide.

Top Cities for Couples Therapy

Where are couples therapists concentrated at the city level? The top 25 cities account for a significant share of the national total. Metropolitan areas with large, affluent populations and major university systems tend to produce and attract the most therapists.

Rank	City	State	Therapist Count
1	Las Vegas	Nevada	575
2	Chicago	Illinois	435
3	Louisville	Kentucky	432
4	Portland	Oregon	404
5	Wichita	Kansas	400
6	Madison	Wisconsin	277
7	Nashville	Tennessee	273
8	Indianapolis	Indiana	272
9	New York	New York	269
10	Seattle	Washington	267
11	Reno	Nevada	265
12	Philadelphia	Pennsylvania	258
13	Atlanta	Georgia	217
14	Honolulu	Hawaii	208
15	Oklahoma City	Oklahoma	201
16	Charlotte	North Carolina	197
17	Denver	Colorado	187
18	Tulsa	Oklahoma	177
19	Minneapolis	Minnesota	165
20	Colorado Springs	Colorado	162
21	Eugene	Oregon	160
22	Albuquerque	New Mexico	157
23	Phoenix	Arizona	147
24	Henderson	Nevada	147
25	Overland Park	Kansas	141

Las Vegas, Nevada tops the list with 575 couples therapists. It is worth noting that some large cities may appear underrepresented because therapists in suburban office parks register under surrounding municipality names rather than the primary city name.

Methodology

This study is based on data from the National Provider Identifier (NPI) Registry, maintained by the Centers for Medicare & Medicaid Services (CMS). The NPI Registry is the most comprehensive public database of healthcare providers in the United States.

We identified 34,963 therapists by filtering for providers with taxonomy codes related to marriage and family therapy, couples counseling, and family counseling. Specifically, we included providers classified under:

• Marriage & Family Therapist (taxonomy code 106H00000X)
• Related subspecialty codes for couples and family counseling

Population data comes from the U.S. Census Bureau's 2024 population estimates. Per-capita calculations use these estimates as the denominator.

Credential categorization was performed by grouping the 129 distinct credential strings found in the NPI data into five major categories (LMFT, LPC, LCSW, Psychologist, Other) based on standard license abbreviation patterns.

Limitations: The NPI Registry captures providers who have registered for a National Provider Identifier, which is required for billing insurance. Therapists who operate exclusively as cash-pay or who have not registered with NPI may not appear in this dataset. Additionally, some therapists may be registered in one state but practice via telehealth in others. Data is current as of March 2026.

About This Study

This research was conducted by CouplesCounselorFinder.com, a free directory that helps people find licensed couples and marriage therapists across the United States. Our directory includes detailed profiles for therapists in every state, making it easy to search by location and credential type.

If you are a journalist, researcher, or policy analyst using this data, we ask that you cite CouplesCounselorFinder.com as the source and link back to this study. For press inquiries or data requests, please contact us through our website.

Ready to find a therapist? Search our directory to browse couples counselors in your state.