North Carolina
Navigating Behavioral Health and Substance Use Disorder Facility Licensing in North Carolina: A Step-by-Step Guide
You can’t start a compliant and successful mental health or substance use treatment program without first ensuring you are adhering to the state’s licensing requirements. Whether you’re seeking to open an outpatient facility (providing outpatient, intensive outpatient/ IOP, or partial hospitalization/ PHP) or a residential facility (detox/ withdrawal management, high intensity or low intensity residential) navigating North Carolina’s regulatory landscape can be complex and time-consuming.
At Arrow Consulting, we specialize in guiding providers through every stage of the licensing process – ensuring your facility meets all regulatory standards and is fully prepared to deliver high-quality, legally compliant care.
Step-by-Step Guide to Getting Licensed in North Carolina
- Decide what service you want to provide and which license you’ll need
Decide whether your facility will provide mental health services or substance use disorder services. This decision determines the regulations you must follow and guides your application process. - Review the regulations for the service you’ll provide
Consult with the North Carolina Department of Health and Human Services (NC DHHS), Division of Health Service Regulation, Mental Health Licensure and Certification Section (MHLC) to review the current requirements for your program type.
You should also consult the NCDHHS to determine whether a Certificate of Need (CON) is required. Since North Carolina is a CON state, certain facility types may need CON approval before you can apply for your license. - Get your documents and processes in order
Compile the documents required for your North Carolina application. You’ll definitely need:
- Organizational formation documents
- Staffing plans
- Facility floor plans/ building documents
- Relevant policies and procedures
- Once you finalize your application, submit it to the state
- Mental Health Facilities (Residential, PHP, IOP): Submit to NC DHHS, MHLC
- Substance Use Disorder Facilities (Detox, Residential, PHP, IOP): Submit to NC DHHS, MHLC
- See below for more information on these agencies
- Prepare for Inspection
Depending on the service and level of care you decide, North Carolina will schedule an on-site inspection to ensure your facility meets all regulatory standards for safety, staffing, documentation, and program operations. Make sure your facility is in good shape and your leadership is prepared! - Make any corrections and start providing services
You may need to make some revisions to policies or other items as discussed with the state. Once you have completed your plan of correction, you will be issued your license and may commence providing services to your community.
Understanding Behavioral Health Facility Licensing Requirements in North Carolina
Licensing for Substance Use Disorder (SUD) Facilities
Substance use disorder treatment facilities in North Carolina are licensed by the North Carolina Department of Health and Human Services (NC DHHS), Division of Health Service Regulation, Mental Health Licensure and Certification Section (MHLC).
PHP and IOP for SUD:
PHP and IOP programs for substance use disorder treatment must provide structured, intensive services and comply with North Carolina requirements for:
- Qualified staffing
- Therapeutic programming
- Patient care standards
- Emergency preparedness
Detox and Residential Treatment:
Detox programs and residential treatment programs in North Carolina must be licensed by NC DHHS, MHLC and meet state standards for:
Medically supervised withdrawal management
- On-site licensed professionals (e.g., physicians and nurses)
- Patient safety and clinical oversight
- Staffing qualifications
- Facility operations and compliance with NC DHHS regulations
Licensing for Mental Health Facilities
Mental health facilities in North Carolina are licensed by the North Carolina Department of Health and Human Services (NC DHHS), Division of Health Service Regulation, Mental Health Licensure and Certification Section (MHLC).
PHP and IOP for Mental Health:
Mental health PHP and IOP programs must meet state standards for:
- Therapeutic services
- Staffing qualifications
- Patient safety
- Quality care
Residential Treatment Facilities in Mental Health:
Facilities providing residential mental health services must be licensed by NC DHHS, MHLC, and are required to meet state standards for:
- 24/7 care in a structured environment
- Therapeutic services
- Staffing qualifications
- Patient safety
- Quality care
Let Arrow Consulting handle the entire process for you – ensuring a smooth, compliant, and efficient licensing experience.