“I’m Licensed in Another State (or Have a Second In-State Virtual Address).  So, Why Don’t I Get Clients There?”

By Barbara Griswold, LMFT (January 10, 2026)

More therapists are practicing across state lines (some legally and some illegally, but we’ll get to that in a moment). They are getting licensed in other states or utilizing interstate compacts like PsyPact and most recently the Counseling Compact (more on these and other compacts in the article below).

Being able to practice in another state opens up so many opportunities. Your potential client pool is greatly expanded. You can see clients who live outside your local area or state. You can continue to see clients who move or travel.

So, you get licensed in another state or set up to use a Compact, or set up a second virtual in-state practice location. Then you advertise. You add the new states or practice location to your Psychology Today profile and your website. Then you wait for the email and phone inquiries to flow in.

But you get no response. What’s going on?

First, let’s review: When can you LEGALLY practice across state lines?  This question continues to confuse many clinicians. Here’s the bottom line:

• If a client is in another state at the time of the session, you may only see them if you are licensed in that other state (or permitted to do so by that state’s licensing board for your license).
• It doesn’t matter where the client’s residence is, or where you are
• It doesn’t matter if the client uses insurance, self-pays, or pays nothing.

For more on this topic, see my Telehealth Law and Ethics Webinar.

OK, back to our question: Why aren’t you getting any referrals from the other state? According to Becky DeGrossa of CounselingWise, “therapists believe if they are licensed in multiple states, they can attract clients in all these states through their website. This isn’t true.”

DeGrossa gives one example: “Imagine you’re sitting in San Francisco searching Google for ‘Chinese food.’ Google doesn’t show you restaurants in Connecticut. It shows you those that are physically nearby you in San Francisco. The same applies to therapy.”

According to DeGrossa, Google will only show therapists who have office listings in the cities where people are searching.  “Google’s local algorithm doesn’t care about your state license,” says DeGrossa. “It cares about your physical office presence in the city where someone is searching.”

In fact, this holds true even within the state where you are physically located.  “Let’s say you’re licensed in California and have an office in San Francisco. Being licensed in California doesn’t mean Google will show your website to someone who is sitting in another part of the state, such as Los Angeles or San Diego, when they search for a therapist.”

How to be successful in a two-location practice

“If you want to attract clients in another city — whether in your state or a different state — you need a physical office there,” says DeGrossa. “It can just be a small office you rent for a few hours a month, or a shared space where you have a key and can verify your location. It just needs to be a legitimate address where Google can confirm that you exist.” This leads Google to believe you belong in that local market.

Says DeGrossa, most therapists who succeed with multi-location practices:

• Choose one city to start, a medium-sized market where they can compete
• Find an office through a therapist who doesn’t view them as competition
• Pay a couple hundred dollars a month for minimal space

Does it sound expensive and complicated?  “It can be, but if you want serious client flow from another location, it may be worth it,” says DeGrossa. “If you just want the flexibility to keep seeing current clients who move, it may not be.”

Want more information and consultation around successful multi-location practices? Consider a consultation with DeGrossa of CounselingWise.   She also runs a “Private Practice Builders” Skool Group where she covers how to choose the right city for expansion, the actual cost of setting up a legitimate second location, how to structure your website for multi-location visibility, and real examples of therapists who’ve done this successfully.

 

Barbara Griswold, LMFT is a private practice coach and the author of Navigating the Insurance Maze:The Therapist’s Complete Guide to Working With Insurance — And Whether You Should, 10th edition.  Check out Barbara’s online catalog of helpful online courses, practice forms, and other therapist resources related to insurance, documentation, and running your therapy business here, and subscribe to her free e-newsletter here.