In 1,609 of 3,135 US counties, the federal NPI Registry lists no psychiatrist with a practice address. 26.3 million people live in them. We counted every licensed behavioral health clinician in the registry by the county of their practice address, and compared it with each county’s population.
Most counties without a psychiatrist are rural, but not all. The largest is Comal County, Texas, home to 209,166 people. Therapists are far more evenly spread than prescribers: only 283 counties list no therapist at all.
Psychiatrists plus psychiatric nurse practitioners, by practice address. Hover or tap a county.
The map loads when you scroll here.
| County | People | Clinicians of any kind | Psychiatric NPs |
|---|---|---|---|
| Comal County, Texas | 209,166 | 90 | 2 |
| Limestone County, Alabama | 122,928 | 45 | 3 |
| Barrow County, Georgia | 99,773 | 20 | 0 |
| Jackson County, Georgia | 99,265 | 30 | 0 |
| St. Clair County, Alabama | 98,206 | 13 | 0 |
| Fairbanks North Star Borough, Alaska | 93,972 | 207 | 2 |
| Elmore County, Alabama | 91,577 | 15 | 0 |
| Bullitt County, Kentucky | 86,454 | 71 | 2 |
| Orange County, Texas | 86,266 | 17 | 0 |
| Talladega County, Alabama | 81,603 | 18 | 2 |
| Caldwell County, North Carolina | 81,105 | 55 | 0 |
| Robertson County, Tennessee | 80,175 | 44 | 3 |
| Morgan County, Indiana | 74,967 | 39 | 1 |
| Effingham County, Georgia | 74,397 | 29 | 0 |
| DeKalb County, Alabama | 74,085 | 18 | 3 |
| Pender County, North Carolina | 72,111 | 55 | 2 |
| San Patricio County, Texas | 72,053 | 23 | 1 |
| Harrison County, Texas | 71,956 | 27 | 3 |
| Hood County, Texas | 70,501 | 57 | 1 |
| Walker County, Georgia | 70,250 | 27 | 0 |
Per 100,000 residents. Tap a column to sort.
| State | People | All clinicians | Therapists | Psychiatrists | Psychiatric NPs | Psychologists |
|---|---|---|---|---|---|---|
| Alabama | 5,193,088 | 92 | 73 | 9.4 | 3.7 | 10.5 |
| Alaska | 737,270 | 410 | 351 | 13.7 | 11.7 | 27.3 |
| Arizona | 7,623,818 | 140 | 94 | 11.8 | 9.0 | 17.7 |
| Arkansas | 3,114,791 | 245 | 201 | 10.7 | 5.5 | 14.3 |
| California | 39,355,309 | 361 | 320 | 20.8 | 3.4 | 43.9 |
| Colorado | 6,012,561 | 340 | 299 | 17.1 | 7.9 | 37.3 |
| Connecticut | 3,688,496 | 382 | 308 | 33.3 | 14.3 | 42.7 |
| Delaware | 1,059,952 | 224 | 168 | 12.9 | 8.0 | 26.6 |
| District of Columbia | 693,645 | 396 | 288 | 48.3 | 8.8 | 82.8 |
| Florida | 23,462,518 | 162 | 126 | 10.8 | 6.3 | 19.3 |
| Georgia | 11,302,748 | 130 | 106 | 10.6 | 3.7 | 16.5 |
| Hawaii | 1,432,820 | 268 | 213 | 22.3 | 4.3 | 54.6 |
| Idaho | 2,029,733 | 215 | 169 | 7.2 | 5.6 | 15.0 |
| Illinois | 12,719,141 | 225 | 188 | 14.8 | 3.8 | 31.7 |
| Indiana | 6,973,333 | 152 | 124 | 8.8 | 4.2 | 16.1 |
| Iowa | 3,238,387 | 161 | 123 | 10.0 | 7.2 | 14.0 |
| Kansas | 2,977,220 | 224 | 159 | 11.4 | 7.4 | 32.2 |
| Kentucky | 4,606,864 | 220 | 177 | 10.2 | 9.3 | 21.8 |
| Louisiana | 4,618,189 | 314 | 263 | 12.7 | 6.5 | 12.5 |
| Maine | 1,414,874 | 462 | 388 | 23.9 | 15.9 | 37.1 |
| Maryland | 6,265,347 | 251 | 193 | 24.1 | 11.6 | 35.3 |
| Massachusetts | 7,154,084 | 594 | 496 | 38.1 | 10.9 | 72.8 |
| Michigan | 10,127,884 | 303 | 229 | 14.6 | 3.6 | 46.0 |
| Minnesota | 5,830,405 | 231 | 201 | 14.7 | 5.8 | 50.6 |
| Mississippi | 2,954,160 | 153 | 125 | 7.2 | 8.3 | 9.1 |
| Missouri | 6,270,541 | 187 | 155 | 12.7 | 4.1 | 21.6 |
| Montana | 1,144,694 | 269 | 240 | 12.5 | 8.6 | 21.0 |
| Nebraska | 2,018,006 | 246 | 213 | 10.6 | 8.1 | 20.9 |
| Nevada | 3,282,188 | 226 | 195 | 8.9 | 5.0 | 19.5 |
| New Hampshire | 1,415,342 | 311 | 259 | 18.4 | 15.4 | 32.4 |
| New Jersey | 9,548,215 | 207 | 168 | 15.9 | 5.5 | 27.1 |
| New Mexico | 2,125,498 | 432 | 340 | 14.6 | 7.7 | 28.4 |
| New York | 20,002,427 | 324 | 218 | 32.5 | 10.3 | 48.7 |
| North Carolina | 11,197,968 | 220 | 194 | 14.5 | 4.9 | 26.1 |
| North Dakota | 799,358 | 252 | 159 | 12.9 | 5.8 | 27.3 |
| Ohio | 11,900,510 | 275 | 198 | 14.0 | 7.4 | 25.2 |
| Oklahoma | 4,123,288 | 395 | 355 | 10.2 | 2.1 | 18.0 |
| Oregon | 4,273,586 | 534 | 464 | 18.4 | 15.1 | 39.5 |
| Pennsylvania | 13,059,432 | 209 | 163 | 19.4 | 3.7 | 34.7 |
| Puerto Rico | 3,184,835 | 120 | 92 | 14.8 | 0.0 | 60.8 |
| Rhode Island | 1,114,521 | 381 | 319 | 34.0 | 8.6 | 55.4 |
| South Carolina | 5,570,274 | 159 | 129 | 10.9 | 3.0 | 10.0 |
| South Dakota | 935,094 | 174 | 142 | 10.9 | 5.5 | 17.4 |
| Tennessee | 7,315,076 | 152 | 117 | 9.4 | 8.6 | 16.6 |
| Texas | 31,709,821 | 104 | 85 | 9.7 | 3.8 | 12.9 |
| Utah | 3,538,904 | 313 | 267 | 9.4 | 6.2 | 19.6 |
| Vermont | 644,663 | 431 | 380 | 30.9 | 10.7 | 77.9 |
| Virginia | 8,880,107 | 163 | 132 | 14.8 | 5.2 | 25.2 |
| Washington | 8,001,020 | 325 | 289 | 14.5 | 9.9 | 29.9 |
| West Virginia | 1,766,147 | 145 | 99 | 11.8 | 3.9 | 26.6 |
| Wisconsin | 5,972,787 | 204 | 167 | 14.2 | 4.8 | 23.4 |
| Wyoming | 588,753 | 320 | 293 | 6.8 | 6.5 | 24.8 |
We started from every record in our copy of the CMS NPI Registry (October 2026) whose primary taxonomy is a licensed behavioral health clinician: psychiatrists, psychiatric nurse practitioners, psychologists, counselors, clinical and other licensed social workers, marriage and family therapists and addiction counselors. That is the same inclusion rule as our search; it leaves out behavior technicians, psychiatric technicians and neurologists. How we verify
Each clinician counts once, in the county where their practice ZIP code has the most land area (Census 2020 ZIP-to-county relationship file). We dropped 23,930 records whose ZIP code didn’t match their state or a county. Populations are Census Bureau estimates for July 1, 2025. Connecticut appears only at state level, because the Census now reports it by planning region rather than county.
What this can’t tell you. A practice address isn’t proof of an open schedule: some clinicians have retired without closing their NPI, some work only in a hospital or prison, and many see patients by video across county lines. Child and adolescent psychiatrists are undercounted, because many list general psychiatry as their primary taxonomy. Treat a zero as “nobody lists an office here”, not “no care exists”.
Free to use under CC BY 4.0. Columns: population, counts by provider type, and the same per 100,000. Suggested citation:
BehavioralHealthGuide.org. “Where America’s mental health clinicians are, county by county.” October 2026. https://behavioralhealthguide.org/research/mental-health-providers-by-county
No. People drive to the next county, see a psychiatrist by video, or get medication from a primary care doctor. The count says where clinicians list a practice address, which is the closest public measure of who is nearby.
We count each clinician once, by the primary taxonomy and practice address on their NPI record. Studies that use licensure files, board certification or insurance claims will count differently. Child and adolescent psychiatrists are especially undercounted here, because many list general psychiatry as their primary taxonomy.
Yes. The CSV files are free under a Creative Commons Attribution 4.0 license. Please cite BehavioralHealthGuide.org and link to this page.
We rebuild it from a fresh copy of the NPI data every few months. The month of the copy is shown at the top of the page.
[1] CMS, NPPES Downloadable Files (NPI Registry)
[2] US Census Bureau, County Population Totals: 2020–2025
[3] US Census Bureau, State Population Totals: 2020–2025
[4] US Census Bureau, 2020 ZCTA to County Relationship File
[5] HRSA, Health Professional Shortage Areas (the federal shortage designations, for comparison)
Published by the BehavioralHealthGuide.org editorial team (Change LLC). Counts come from public federal data; nobody paid for this analysis or for any listing on this site. General information, not medical advice.