Author: A. Ant, CADC-II, Licensing & Accreditation Expert
Disclaimer: This content is provided for general informational purposes only and should not be construed as legal, regulatory, or licensing advice. Requirements change frequently. Consult qualified professionals for guidance specific to your situation.
The only program-level credential South Dakota offers an outpatient mental health provider is accreditation as a community mental health center, and the statute behind it says what it is for. SDCL 27A-5-1 tells the Department of Social Services to set standards for “locally operated nonprofit mental health centers” so they can “qualify for assistance from the State of South Dakota.” A private therapy or psychiatry practice is not that, and we found no state facility license built for it. What governs a private practice is the license each clinician holds, and the counseling board puts the floor plainly: “No one is allowed by law to do professional counseling for a fee without a license.”
Three Ways an Outpatient Mental Health Practice Can Be Set Up
Rows two and three restate ARSD 67:62 and 67:61. The private practice row is our reading of what the statutes and rules leave out.
| Model | Who oversees it | Program credential | Main rule |
|---|---|---|---|
| Private group or solo practice | Clinicians’ own licensing boards | None that we found | Individual practice acts, such as the counselor licensing law administered by the Board of Examiners for Counselors and Marriage and Family Therapists |
| Community mental health center | DSS Office of Licensing and Accreditation | DSS accreditation | SDCL 27A-5, ARSD 67:62 |
| Practice adding substance use outpatient or IOP | DSS Office of Licensing and Accreditation | DSS accreditation if the agency applies | SDCL 34-20A, ARSD 67:61 |
A Private Practice Runs on Individual Licenses
As far as we read it, the Department of Health’s facility licensure page names no outpatient mental health clinic among the types it licenses, and DSS accreditation under ARSD 67:62 is written for centers. Our reading is that an office practice with no beds holds no organization license and is regulated through its clinicians. That reading rests on what we did not find, so confirm it with DSS (605.367.5236, dssbh@state.sd.us) before you open.
For counselors, South Dakota uses two steps. According to the Board of Examiners for Counselors and Marriage and Family Therapists, “you must hold the LPC (Licensed Professional Counselor) before you can qualify for the LPC-MH.” The LPC takes 2,000 hours of post-graduate supervised experience and 100 hours of supervision. The LPC-MH adds 2,000 hours of direct client contact in a clinical setting and another 100 hours of supervision under a board-approved Plan of Supervision. The board’s LPC-MH page asks for “a 48-hour master’s degree in counseling from an accredited institution,” a passing National Counselor Examination before the plan is approved, and the NCMHCE once the hours are done. It also warns that “No supervision or direct client contact hours will be counted towards licensure” before the plan is approved, which matters when you hire a new LPC and expect their hours to start on day one.
Becoming an Accredited Community Mental Health Center
ARSD 67:62:02:03 is short: “A center seeking to operate as an accredited community mental health center must submit an application for accreditation to the department.” The Office of Licensing and Accreditation lists the center service levels as including Outpatient Services, Comprehensive Assistance with Recovery and Empowerment (CARE), and Individualized Mobile Programs of Assertive Community Treatment (IMPACT). Applications open through the portal’s behavioral health inquiry page (its menu calls it Become a Provider), and the office answers at 605.773.3165, 700 Governors Drive, Pierre, SD 57501.
ARSD 67:62:02:20 also ties certain state and federal funds to DSS accreditation, a funding matter outside the license that we do not handle. On the reporting side, the center rule, ARSD 67:62:02:19, still carries the title “Sentinel event notification.” The 24-hour notice to DSS covers deaths not explained mainly by the course of a client’s illness or condition, along with permanent harm, severe temporary harm and life-sustaining interventions, and a follow-up report is owed within 72 hours. One more date to note: the definitions in ARSD 67:62:01:01 were amended effective July 1, 2026, so check them against any policy manual written before then.
When a Therapy Practice Adds Substance Use Treatment
Substance use outpatient, intensive outpatient and early intervention programs sit under ARSD 67:61, a separate DSS accreditation. The rule says an agency “may apply,” and our reading of SDCL 34-20A is that it never makes accreditation a condition of operating, but insurance approval under SDCL 58-18-7.1 and court commitments turn on it. Inside an accredited program, ARSD 67:61:05:03 requires that “An addiction counselor must obtain certification and an addiction counselor supervisee or trainee must obtain recognition before performing any addiction counseling functions,” which means credentials from the Board of Addiction and Prevention Professionals. The full outpatient picture is in South Dakota Drug and Alcohol Outpatient Treatment Licensing.
Ketamine and Spravato in a South Dakota Therapy or Psychiatry Office
No South Dakota rule for outpatient mental health mentions ketamine. The statute and federal rule language below is quoted as written. Fitting it to an office practice is our interpretation.
Because the state licenses no outpatient mental health facility, there is no facility license that ketamine has to fit inside. None of the DOH facility types we reviewed covers an office infusion practice either. The obligations follow the prescriber and the drug. Federal law lists ketamine in Schedule III (21 CFR 1308.13(c)(7)), each office that stocks it needs its own DEA registration under 21 CFR 1301.12(a), and anyone who dispenses, administers or prescribes controlled substances in South Dakota also needs a DOH controlled substance registration (605-773-3356). The prescription monitoring statute, SDCL 34-20E-2, makes each dispenser report “each prescription dispensed.” Nothing is dispensed when a clinician gives the dose in the office, so we read those doses as outside the reporting duty. A prescription the patient fills at a pharmacy and takes home is a different story and gets reported.
Ownership is where a counseling group has to slow down. SDCL 36-4-8.1 sets the state’s policy that “a corporation may not practice medicine or osteopathy,” with an exception for medical corporations under chapter 47-11, where SDCL 47-11-3 limits officers, directors and shareholders to people licensed under the Medical Practice Act, and a narrow one for employment: “A corporation is not engaged in the practice of medicine or osteopathy” when it employs a licensed physician under an agreement that leaves medical judgment with the physician, keeps the corporation’s take from the physician’s services to reasonable add-on charges such as facility, equipment or administrative fees, and runs no longer than three years before annual renewals. A therapy group that wants a psychiatrist’s ketamine service should check its structure against that statute with a South Dakota health care attorney before the first dose. Clinic ownership gets a longer treatment in the ketamine section of South Dakota Drug and Alcohol Outpatient Treatment Licensing.
A South Dakota CNP may be the prescriber. The Board of Nursing’s 2022 licensure instructions say CNPs “may prescribe, procure, furnish, and administer” controlled substance drugs, and that a CNP without 1,040 hours of licensed NP practice must file a collaborative agreement with a South Dakota physician or CNP. We did not check the current statute for changes since 2022. For RN-run infusions, the board’s IV infusion guidelines do not mention ketamine. Spravato has a tighter federal rule. Its label says it “can only be administered at healthcare settings certified in the SPRAVATO REMS program,” that “Patients treated in outpatient healthcare settings (such as medical offices and clinics) must be enrolled in the program,” and that the provider must watch the patient for at least 2 hours after a dose.
Staffing a South Dakota Outpatient Practice
BLS’s May 2025 figures for substance abuse, behavioral disorder and mental health counselors in South Dakota run from $45,650 at the 25th percentile to $62,660 at the 75th, with the median at $53,650 (BLS OEWS). Nationally the median is $59,350. By our arithmetic, a pair of therapists at the state median costs $107,300 a year, not counting a clinical lead, benefits or prescriber time. The LPC step in South Dakota’s licensing ladder is what keeps a new practice’s payroll manageable. An LPC-MH supervising LPCs who are working through their 2,000 direct client contact hours under an approved Plan of Supervision, paid at LPC rates while they do it, commonly keeps what you spend on therapists 40 to 60 percent under a roster made up only of fully licensed LPC-MHs. If the practice adds medication management or Spravato, an RN who supervises a couple of LPNs is cheaper than putting an RN in every chair. The service mix you choose sets the actual numbers.
Mistakes That Cost South Dakota Practices Time
Hiring an LPC and counting their hours before the board approves the Plan of Supervision is the most expensive mistake on this list, because those hours do not count. Next is a therapy practice that starts offering substance use counseling without checking BAPP credentials or deciding whether to seek DSS accreditation. The last one is ownership. A group that brings in a prescriber without reading SDCL 36-4-8.1 can end up restructuring after it opens.
Frequently Asked Questions
Is there a South Dakota facility license for a private therapy practice?
Not one that we found. We saw no DOH facility type for an outpatient mental health clinic, and DSS accreditation under ARSD 67:62 is for community mental health centers. The clinicians must be licensed, though, and the counseling board says no one may do professional counseling for a fee without a license. Confirm your model with DSS before opening.
What is the difference between an LPC and an LPC-MH in South Dakota?
The LPC comes first and requires 2,000 hours of post-graduate supervised experience plus 100 hours of supervision. The LPC-MH requires holding the LPC, then 2,000 hours of direct client contact in a clinical setting and another 100 hours of supervision under a board-approved Plan of Supervision, along with the NCMHCE.
Who accredits community mental health centers in South Dakota?
The DSS Office of Licensing and Accreditation, under SDCL 27A-5 and ARSD 67:62. A center files through the office’s Become a Provider inquiry form and is accredited for service levels such as outpatient, CARE and IMPACT.
Working out where LPC hours or a prescriber fit in a South Dakota practice? We can talk it through.
Sources
- SDCL chapter 27A-5, including 27A-5-1: SDCL 27A-5 (checked October 15, 2026)
- ARSD 67:62:02 (center accreditation, event notification, funds): ARSD 67:62:02 (checked October 15, 2026)
- ARSD 67:62:01 (definitions, amended July 1, 2026): ARSD 67:62:01 (checked October 15, 2026)
- ARSD 67:61:02:03 and 67:61:05:03: ARSD 67:61:02 and ARSD 67:61:05 (checked October 15, 2026)
- SDCL chapter 34-20A, including 34-20A-2.1 and 34-20A-77: SDCL 34-20A (checked October 15, 2026)
- DSS Office of Licensing and Accreditation: Behavioral Health and Become a Provider inquiry (checked October 15, 2026)
- DSS Division of Behavioral Health, Staff Directory (February 2026): Staff Directory (PDF) (checked October 15, 2026)
- DOH, Healthcare Facility Licensure (facility types): Healthcare Facility Licensure (checked October 15, 2026)
- Board of Examiners for Counselors and Marriage and Family Therapists: FAQ and LPC-MH (checked October 15, 2026)
- Board of Addiction and Prevention Professionals: BAPP (checked October 15, 2026)
- SDCL 36-4-8.1 (corporate practice of medicine): SDCL 36-4-8.1 (checked October 15, 2026)
- SDCL 47-11, including 47-11-3 (medical corporation officers, directors and shareholders): Medical Corporations (checked October 15, 2026)
- SDCL 34-20E-2 (prescription monitoring reports): SDCL 34-20E-2 (checked October 15, 2026)
- DOH, Controlled Substance Registration: Controlled Substance Registration (checked October 15, 2026)
- South Dakota Board of Nursing, CNP licensure instructions (April 2022): CNP instructions (PDF) (checked October 15, 2026)
- South Dakota Board of Nursing, Elective IV Infusion and Medication Therapy Guidelines (2022): IV infusion guidelines (PDF) (checked October 15, 2026)
- 21 CFR 1308.13(c)(7), via Cornell LII: Ketamine in Schedule III (checked October 15, 2026)
- 21 CFR 1301.12(a), via Cornell LII: Separate DEA registration for each location (checked October 15, 2026)
- U.S. FDA, Spravato prescribing information and Medication Guide: Spravato label (PDF) (checked October 15, 2026)
- U.S. Bureau of Labor Statistics, OEWS May 2025, SOC 21-1018: South Dakota OEWS and national estimates (checked October 15, 2026)
Leave a Reply