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The renewal process for the Licensed Professional Clinical Counselor (LPCC) credential in Kentucky is an important matter for professionals in the mental health field. The Kentucky Board of Licensed Professional Counselors manages this process through a specific renewal application form that must be completed and submitted annually. This form not only requires important personal and professional information, such as the counselor's name, employment details, and contact information, but also includes several questions pertaining to legal and disciplinary matters. Counselors must affirm that they have met the continuing education requirements, a crucial element for maintaining this credential. Additionally, there is a fee associated with the renewal, which is $150, payable to the Kentucky State Treasurer. Notably, if the form and payment are not submitted by the deadline of October 31, the license may be deemed inactive, necessitating a formal cessation of the title until reinstatement occurs. This renewal application highlights the responsibility and accountability expected of licensed professionals, ensuring they uphold the standards of the counseling profession in Kentucky.

Ky Lpcc License Example

2011 Edition

KENTUCKY BOARD OF LICENSED PROFESSIONAL COUNSELORS

PO BOX 1360

FRANKFORT KY 40602

http://lpc.ky.gov

RENEWAL APPLICATION FOR LICENSED PROFESSIONAL CLINICAL COUNSELOR

Your Licensed Professional Clinical Counselor credential expires on October 31, 2011. In accordance with KRS 335.535 and regulations (201 KAR 36:020) governing this profession, you are required to renew your license annually with the transmittal of this form and a renewal fee of $150.00, (check or money order) made payable to the Kentucky State Treasurer. Please return this completed form with the fee to the address above prior to the deadline date of October 31,2011. The fee for renewals received during the 60 day grace period is $25.00. Credentials not renewed prior to December 31,2011 will be terminated and you must immediately CEASE AND DESIST (no exceptions) the use of the title Licensed Professional Clinical Counselor in Kentucky.

If your renewal reminder indicated that you had been selected for AUDIT please send copies of evidence of having completed 10

hours of continuing education as defined in 201 KAR 36:030.

PLEASE COMPLETE ALL OF THE FOLLOWING:

Name

 

 

Present place of employment

 

Address

 

 

Address

 

 

Address

 

 

Address

 

 

City

State

Zip

City

State

Zip

Home telephone number

 

 

Business telephone #

 

Home e-mail address

 

 

Business e-mail address

 

_______________________________________________

License number

 

 

Social Security Number

 

 

 

 

 

(Please complete hack page ofrenewalform)

2011 Edition

1. Have you been convicted of a felony since your last application or renewal? “Conviction” including all instances in

which a plea of no contest is the basis of the conviction.

(

)No

(

 

)Yes

If yes, list offense and provide details on a separate sheet of paper.

 

 

 

 

 

2. Have you been subject to disciplinary action by a mental health credentialing board?

(

)No

 

(

) Yes

If yes, give details on a separate sheet of paper.

 

 

 

 

 

3.List any state in which you have become licensed or certified since your last renewal, the type of license or certification, and the number of the certification or license:

4. Are you currently serving in the military? (

) No

(

) Yes

5.If you are currently eligible to supervise LPCA’s please provide date of completion of required supervision training: Date of Board Approved Supervision Training

CERTIFICATE OF COMPLIANCE

I do certify under penalty of law that the information contained herein is true, correct, and complete to the best of my knowledge and belief. I am aware that, should investigation at any time disclose any such misrepresentation or falsification, my license could be subject to disciplinary action by the Kentucky Board of Licensed Professional Counselors

I have completed

hours of continuing education during the annual period for renewal as defined in 201 KAR 36:030.

If your renewal application indicates that you have been selected for AUDIT please send copies of evidence ofhaving completed 10

hours ofcontinuing education as defined in 201 KAR 36:030.

Signature:

Date:

/________ /________

 

(Sign your name - Do not print or type)

 

Form Characteristics

Fact Name Description
Renewal Requirement The renewal application for the Licensed Professional Clinical Counselor (LPCC) must be submitted annually.
Expiration Date Your LPCC license expires on October 31, 2011. Failure to renew by this date results in termination of the license.
Governing Laws This renewal process is governed by KRS 335.535 and regulations as stated in 201 KAR 36:020.
Renewal Fee The renewal fee is $150.00, payable by check or money order to the Kentucky State Treasurer.
Grace Period Fee If submitted within 60 days after the expiration, a reduced fee of $25.00 applies.
Continuing Education Applicants selected for audit must provide proof of 10 hours of continuing education as per 201 KAR 36:030.

Guidelines on Utilizing Ky Lpcc License

Filling out the Kentucky Licensed Professional Clinical Counselor (LPCC) renewal application is straightforward. Make sure to provide accurate information and complete all required sections to avoid any delays in processing your renewal.

  1. Obtain the renewal application form from the Kentucky Board of Licensed Professional Counselors or download it from their website.
  2. Complete the sections regarding your personal information, including your name, current place of employment, and contact details.
  3. Enter your license number and Social Security number (make sure this is accurate to prevent issues).
  4. Answer the felony conviction question truthfully. If applicable, provide details on a separate sheet.
  5. Indicate if you have faced disciplinary action by a mental health credentialing board. If yes, give details on a separate sheet.
  6. List any states where you have gained new licensure or certification since your last renewal, including the type and license number.
  7. Clarify your current military status by selecting "Yes" or "No".
  8. If eligible to supervise LPCA’s, provide the date of completion for the required supervision training.
  9. Review the certificate of compliance statement to confirm the accuracy of the information provided.
  10. Sign and date the application at the bottom. Ensure your signature is handwritten, not printed or typed.
  11. Prepare a check or money order for the renewal fee of $150.00, made payable to the Kentucky State Treasurer.
  12. Send the completed form and payment to the address provided on the application before the deadline.

After submitting your application, the board will review it. Keep a copy of the application for your records. If there are any issues, you will be contacted for clarification or additional information.

What You Should Know About This Form

1. What is required to renew my Ky LPCC license?

To renew your Licensed Professional Clinical Counselor (LPCC) license in Kentucky, you must complete the renewal application form and submit it along with a fee of $150. This payment can be made via check or money order, payable to the Kentucky State Treasurer. It's essential to return the completed form and payment before the deadline of October 31. If you miss this deadline, you can still renew during a 60-day grace period for a reduced fee of $25. After December 31, however, you must cease using the title until the license is renewed.

2. What happens if I do not renew my license on time?

If your license is not renewed by December 31, it will be terminated. This means you must immediately stop using the title Licensed Professional Clinical Counselor in Kentucky. Reactivating your license after termination may involve additional steps, so it's vital to adhere to renewal deadlines.

3. What if I've been convicted of a felony since my last renewal?

If you have been convicted of a felony since your last application or renewal, you must disclose this information on a separate sheet of paper. The form prompts you to indicate if you have had such a conviction, as it will be taken into account during the renewal process. Transparency is crucial here, as it may impact your eligibility.

4. Are there any continuing education requirements for renewal?

Yes, to maintain your LPCC license, you must complete at least 10 hours of continuing education during the renewal period. If your application indicates you are selected for an audit, you'll need to provide documented proof of these hours. Fulfilling these continuing education requirements ensures you remain up-to-date in your field.

5. What if I’m currently serving in the military?

If you are currently serving in the military, you will need to indicate this on the renewal application. Military service can sometimes affect licensing and renewal processes; therefore, it’s important to specify your status when submitting your application. If additional guidelines apply to your situation as a service member, the board will typically provide relevant instructions.

6. Can I supervise LPCA trainees?

If you are eligible to supervise Licensed Professional Counselors Associates (LPCA), you need to provide the date of completion for your required supervision training on the application form. This indicates your qualification to take on supervisory roles, which can be an important aspect of your professional practice.

7. What should I do if my application is audited?

If your renewal application indicates that you have been selected for an audit, you are required to submit evidence showing you have completed the mandatory 10 hours of continuing education. This documentation must accompany the renewal application to ensure the board can verify your compliance. Keep all related records and any certificates of completion handy for this purpose.

Common mistakes

Filling out the Ky LPCC License renewal form correctly is essential to avoid delays and complications. One common mistake is neglecting to provide the correct fee. Ensure that the fee is accurately calculated and made payable to the Kentucky State Treasurer. Missing this crucial detail may lead to the rejection of the application.

Another frequent error is not signing the application. The form requires a signature, and failure to include it will result in an incomplete submission. Remember, do not print or type your name; sign it as stated in the guidelines.

People often overlook filling out the home and business telephone numbers. Providing this contact information is important for communication purposes. Missing these can delay your application process significantly.

Omitting responses to the questions regarding felony convictions or disciplinary actions is a significant blunder. You must answer both questions honestly, even if the answer is no. Incomplete responses can flag your application for further review, causing potential delays.

When listing any additional licenses obtained since the last renewal, applicants sometimes forget to include the license numbers. Ensure that all relevant details, including state and type of certification, are up to date.

People frequently make the mistake of not including their social security number on the application. This is a requirement and not including it could lead to processing issues. Double-check that this information is accurately entered.

Many applicants do not pay attention to the continuing education requirements. If selected for audit, you must provide evidence of completing the required hours. Failure to include this documentation may result in complications regarding your renewal.

Another common issue is submitting the application after the deadline. Make sure to postmark your application by the specified deadline to avoid late fees or even termination of your license.

Some individuals also forget to thoroughly review the completed application before submission. Minor mistakes can lead to significant delays. Taking a few moments to check for completeness and accuracy can make a substantial difference.

Lastly, neglecting to keep a copy of the submitted application for personal records can create issues down the line. If any discrepancies arise, having a copy on hand will assist in resolving matters efficiently.

Documents used along the form

When preparing to apply for or renew a Licensed Professional Clinical Counselor (LPCC) license in Kentucky, several additional forms and documents may be required. Each of these plays a crucial role in ensuring compliance with state regulations. Here’s a brief overview of some key documents that often accompany the KY LPCC License form.

  • Continuing Education Documentation: Proof of completed continuing education courses is necessary to demonstrate ongoing professional development and adherence to state requirements.
  • Criminal Background Check Form: This form is used to report any criminal convictions since the last renewal. Transparency in criminal history is essential for maintaining licensure.
  • Disciplinary Action Disclosure: If applicable, this document outlines any disciplinary actions taken against the applicant by a mental health credentialing board, which must be disclosed for licensure integrity.
  • Supervision Training Verification: For those eligible to supervise Licensed Professional Counselor Associates (LPCAs), proof of completion of supervision training is required to ensure the supervisor meets necessary qualifications.
  • Military Service Documentation: Those currently serving in the military need to submit documentation to acknowledge their status, as it may impact licensure requirements.
  • License Verification from Other States: If the applicant has obtained licenses in other states since their last renewal, verification documentation must be submitted detailing the license type and status.
  • Renewal Application Fee Payment: A payment stub or receipt showing the payment of the annual renewal fee (currently $150) is required to process the renewal application smoothly.
  • Audit Notification Acknowledgment: If selected for audit, acknowledgment of receipt of such notice, along with any requested documentation, must be prepared and submitted promptly.
  • Updated Contact Information Form: To ensure that all communication is effective, any updates to phone numbers or email addresses should be submitted alongside the renewal application.
  • Affidavit of Compliance: This legal declaration confirms that all information provided is accurate, and it holds the applicant accountable for any misrepresentation.

By gathering these documents well in advance, one can facilitate a smoother renewal process for the LPCC license. Staying organized not only streamlines compliance but also helps avoid potential delays or issues with licensure.

Similar forms

The Kentucky Licensed Professional Clinical Counselor (LPCC) license renewal application shares similarities with various other professional licensing and renewal documents. Below is a list of nine such documents and how they are similar to the Ky LPCC License form.

  • Social Work License Renewal Application: This form typically requires personal identification details, renewal fees, and evidence of continuing education, just like the Ky LPCC License form.
  • Nursing License Renewal Application: Similar to the LPCC license, this document involves affirming compliance with state regulations and submitting proof of continuing education credits.
  • Psychology License Renewal Application: Both documents necessitate disclosure of any felony convictions and disciplinary actions from other boards, ensuring compliance and accountability.
  • Medical License Renewal Application: The structure often includes a certification of compliance statement along with a requirement to report any legal or disciplinary issues since the last renewal.
  • Marriage and Family Therapy License Renewal Application: Similar to the LPCC form, this document requires applicants to report recent changes in licensure in other states and confirm the completion of required education hours.
  • Substance Abuse Counselor License Renewal Application: Like the Ky LPCC License, this renewal application often includes sections on professional ethics, legal compliance, and updates on continuing education requirements.
  • Occupational Therapy License Renewal Application: Both forms require a renewal fee, self-certification of accuracy in disclosures, and documentation of continuous education relevant to the field.
  • Physical Therapy License Renewal Application: The application process generally includes a certification of compliance with state rules and regulations, similar to the LPCC licensing requirements.
  • Chiropractic License Renewal Application: This document also necessitates details about ongoing education, compliance with legal standards, and attestation of the truthfulness of the information provided.

In summary, these documents reflect a common theme of maintaining professional standards and accountability through regular renewal processes, personal disclosures, and proof of ongoing education.

Dos and Don'ts

When preparing to fill out the Kentucky LPCC License form, certain practices can ensure a smoother experience, while others may hinder your application process. Below is a list of dos and don'ts to consider:

  • Do read the entire form carefully before starting. Understanding all requirements will help you avoid mistakes.
  • Do provide accurate and complete information. Inaccuracies can lead to delays or denial of your application.
  • Do submit your application before the deadline. Late submissions can incur additional fees and may jeopardize your license status.
  • Do include your renewal fee in the appropriate amount. Make sure your payment method is correct to avoid any processing issues.
  • Don't ignore the sections regarding felony convictions or disciplinary actions. Failing to disclose this information can have serious consequences.
  • Don't forget to sign the form. An unsigned application is considered incomplete and will not be processed.

By following these guidelines, you can help ensure that your LPCC renewal process proceeds smoothly and without unnecessary complications.

Misconceptions

Misconceptions about the Kentucky Licensed Professional Clinical Counselor (LPCC) license renewal process can cause confusion and affect compliance. Below are six common misconceptions explained.

  • The renewal application is optional. Many believe that renewing their LPCC license is not necessary. However, it is a mandatory requirement for practicing legally in Kentucky.
  • Renewal deadlines are flexible. Some think they can submit their renewal application anytime without penalties. In fact, the renewal must be completed by October 31 each year, or late fees apply.
  • Continuing education hours are not required. A common myth is that continuing education isn't necessary for renewal. In reality, 10 hours of continuing education are needed to maintain your license.
  • Late renewals automatically extend the license. Some individuals believe that renewing their license after the deadline will keep it active. Unfortunately, if the renewal is not completed before December 31, the license is terminated.
  • Only new felony convictions matter. Many assume previous felony convictions do not affect their ability to renew. However, any felony conviction since the last application or renewal must be disclosed.
  • Renewal fees can be paid in any form. It's a misconception that any payment method is acceptable. The renewal fee must be paid via check or money order, specifically made out to the Kentucky State Treasurer.

Understanding these misconceptions can help ensure a smooth renewal process for Licensed Professional Clinical Counselors in Kentucky.

Key takeaways

When it comes to filling out and using the Kentucky Licensed Professional Clinical Counselor (LPCC) License form, here are some important points to keep in mind:

  • Renewal Deadline: Your LPCC license must be renewed by October 31 each year to avoid any lapse in credentials.
  • Renewal Fee: A fee of $150 is required for license renewal. This can be paid via check or money order, made out to the Kentucky State Treasurer.
  • Grace Period: If you miss the renewal deadline, you have a 60-day grace period to submit your application. During this time, the renewal fee drops to $25.
  • License Termination: If you do not renew your license by December 31, your license will be terminated. This means you cannot use the title of LPCC in Kentucky.
  • Continuing Education: You must complete 10 hours of continuing education annually. If your renewal notice indicates an audit, be prepared to provide proof of these hours.
  • Important Questions: The form includes vital questions about felony convictions, disciplinary actions, and military service. Be truthful when answering.
  • Signature Required: Finally, make sure to sign the form. A printed or typed name is not acceptable; your signature is necessary for the certification of compliance.

Make sure to follow these guidelines closely to ensure a smooth renewal process for your LPCC license!