VERIFICATION OF MARRIAGE AND FAMILY THERAPY LICENSURE FORM (an electronic or paper copy of your license can be sent in lieu of this form)


I have applied to the National Credentialing Academy and am required to provide verification of my license and/or registration granted by your board. Please complete the information requested below and mail the form directly to NCA at the address below. My application cannot be processed until this form is received.

NOTE: Applicant may submit photocopy of their licensure in lieu of this form.