A Common Scenario: Two Websites, One Decision
Say you want to try acupuncture, and two local websites look equally professional. Both list letters after a name. Neither tells you what those letters mean in your state.
Here is the short answer. Before you book, check three things: what your state requires for that type of practitioner, which license or certification this person holds, and whether that credential covers the service being offered. The rest of this guide shows how, step by step.
If you are having a medical emergency, call your local emergency number right away. This guide is not for emergencies.
The Key Fact: There Is No National System
The National Center for Complementary and Integrative Health (NCCIH), part of the U.S. National Institutes of Health, says there is no standardized national system for credentialing complementary health practitioners. State governments decide what credentials a practitioner needs to work in that state. Requirements also differ from one type of practitioner to another.
That is why the same title can mean different things in different places. It is also why this checklist starts with your state.
Stage 1: Learn How Your State Handles the Practice
NCCIH describes three common ways states credential practitioners:
- Mandatory licensure: a person must hold a license to provide the service.
- Title licensure: a person must hold credentials before using a professional title.
- Registration: a person must give a state consumer protection agency information about their training and experience.
These are different levels of oversight. If your state uses title licensure, ask the board whether the rule covers only the title or also limits the service itself. The answer can change what a title tells you.
Licensing rules can also vary in what services a practitioner may offer. NCCIH points to chiropractic as an example, where a national survey found large differences among states in the services chiropractors are allowed to perform.
Stage 2: Read the Credential Words Carefully
NCCIH uses “credentials” as a broad word for a practitioner's license, certification, or education. It separates them this way:
- License: granted and monitored by government agencies.
- Certification: granted by professional organizations. It can be required before a license, or in some cases can stand in for one.
- Education: the school or training program. In the U.S., the Department of Education authorizes specific organizations to accredit education and training programs. NCCIH names the Council on Chiropractic Education and the Accreditation Commission for Acupuncture and Oriental Medicine as examples.
To earn a license, states may require graduation from an approved program, national certification, a set amount of training, an exam, or continuing education. NCCIH gives some examples of how this looks in practice:
- Chiropractors must be accredited Doctors of Chiropractic and pass state exams, National Board exams, or both, in all 50 states and D.C.
- Only 17 states and D.C. license naturopathic physicians.
- In states that regulate massage therapy (45 states and D.C., according to NCCIH's massage therapy fact sheet), therapists must get a license or certification before practicing. Regulations typically require graduation from an approved program and passing an exam.
Date check: NCCIH last updated its credentialing page in May 2018 and its massage fact sheet in May 2019. State laws change, so treat these numbers as examples of variety, not current counts. Your state's licensing board is the place to confirm today's rules.
Stage 3: Check With the Right Sources
NCCIH's tips for choosing a practitioner say to start by checking with your doctor or other health care provider. Other places that may help you find names of practitioners include:
- a nearby hospital or medical school
- professional organizations for that type of practitioner
- state regulatory agencies or licensing boards
- your health insurance provider
NCCIH itself does not refer people to practitioners and is not involved in training, credentialing, or licensing them. Its role is research and public information.
Our practical suggestion: when you contact a state board, ask what it can tell you about the license, such as whether it is current. Boards differ in what they share, so ask before you assume.
Stage 4: Ask Practical Questions
NCCIH advises finding out about a practitioner's education, training, licensing, and certifications, and choosing a practitioner as carefully as you would choose a conventional provider. Here are questions built from that advice:
- What license or certification do you hold, and who issued it?
- Where did you train, and was the program accredited?
- Will you work together with my other health care providers?
- What is your training and experience with people who have my health conditions?
- Will my insurance cover this? (Ask the insurer directly. NCCIH says not to assume coverage.)
Also tell every provider you see about every approach you use. That helps keep your care coordinated and safe.
If you are looking at a specific kind of session, see our guides on yoga safety questions, instructor training, and health history and on preparing for a massage therapy intake: medicines, recent procedures, skin changes, and comfort boundaries.
Warning Boundaries: What a Credential Cannot Tell You
A credential is not a guarantee. NCCIH states that being licensed or certified is not always a guarantee of being qualified. A credential is a starting point, not a finish line.
A credential is not a research finding. In our reading, a license speaks to a person's training, not to whether a practice works for a condition. To learn how to read studies of one common practice, see our guide to acupuncture research, sham comparisons, and blinding.
Popular words are not credentials. NCCIH explains that “complementary” means a non-mainstream approach used together with conventional medicine, and “alternative” means one used in place of it. “Integrative” means bringing the two together in a coordinated way. NCCIH also notes that “functional medicine” is used in different ways. Terms like these describe how approaches are used. A word on a website is not proof of a license, so look up the license itself.
Do not use an unproven approach to delay care. NCCIH advises against using any product or practice that has not been proven safe and effective as a reason to postpone seeing your health care provider. It also warns that stopping or not starting conventional treatment can have serious consequences. Talk with your health care providers before making any change to your treatment.
Watch the language. NCCIH lists phrases to be careful with, including “miracle cure,” “secret ingredient,” and “ancient remedy.” It also says claims that something cures a disease or works for many different ailments usually sound too good to be true.
Credentials do not cover products. For a practitioner-delivered practice, NCCIH says training, skill, and experience matter for safety. For a dietary supplement or herbal product, it says the specific ingredients and manufacturing quality matter. NCCIH also says “natural” does not always mean “safe,” and some herbs can interact with medicines. Its Herbs at a Glance series gives basic facts and cautions for specific herbs. Our guides on identifying an herb by scientific name, plant part, and product form and on questions to bring when a supplement and prescription may interact can help you prepare. Bring what you find to your pharmacist or prescriber before you use a product.
Your Decision Path
- Name the type of practitioner. Acupuncturist, chiropractor, massage therapist, naturopathic physician, and so on. Rules differ for each.
- Find your state's rule. Ask your state's licensing board or regulatory agency whether the practice requires a license, a title credential, or registration.
- If the state requires a license, ask the practitioner for the license details and check them with the board.
- If the state does not regulate the practice, you will need to look harder at training, certification, and references. A missing state rule does not mean a missing risk.
- Check the certification and school. Ask which organization certified them and whether their school was accredited.
- Ask the practical questions from Stage 4.
- Tell your other providers. Share what you plan to try and ask them for their view.
- Pause if something feels off. Vague credentials, pressure to decide fast, or promises of cures are reasons to slow down and get a second opinion.
Evidence Map: What We Know and Don't Know
- Verified by NCCIH: There is no national credentialing system. States set the rules, and they vary by state and by discipline. Licenses, certifications, and education are different things. A credential is not always proof of qualification. NCCIH does not refer people to practitioners.
- NCCIH guidance: Choose a complementary practitioner as carefully as a conventional one. Ask about training and licensing. Make sure the practitioner will work with your other providers. Tell all providers about everything you use.
- Uncertain or dated: Exact state-by-state counts change. The NCCIH examples above come from pages last updated in May 2018 and May 2019.
- Our own framing: The suggested board questions, the decision path, and the note that a credential is not a research finding.
- Not covered here: This guide does not tell you what your state requires today, and it does not rate any practitioner or approach.
About This Page
By the Integrative Health Evidence Guide Team. Updated September 23, 2026.
This guide is built from public information from the National Center for Complementary and Integrative Health: Complementary, Alternative, or Integrative Health: What's In a Name?, Herbs at a Glance, Credentialing, Licensing, and Education, 6 Things To Know When Selecting a Complementary Health Practitioner, Are You Considering a Complementary Health Approach?, and Massage Therapy: What You Need To Know. Statements about what NCCIH says are attributed to it. Suggested questions and next steps are our own practical framing.
This page is published on the Integrative Health Evidence Guide website. It is general education written by the site's editorial research team. It credits no doctor, clinician, or agency as an author or reviewer, and no agency endorses it. It does not rate, recommend, or vouch for any practitioner or practice, including any practice that shares this website.
Educational disclaimer: This article is general information, not medical advice and not legal advice. It does not diagnose, treat, or recommend any approach. Licensing laws differ by state and change over time, so confirm current rules with your state's licensing board. Talk with your own licensed health care provider before making decisions about your care, and never start, stop, or change a medicine without their guidance.