Psychiatric Nurse Practitioners vs Psychiatrists, State by State

In the federal NPI registry as of November 2, 2026, psychiatric nurse practitioners (PMHNPs) outnumbered psychiatrists in each of the states we serve: Texas, New Mexico, Florida, Alaska, Arizona, Colorado and Washington. The ratio ran from 1.13 PMHNPs per psychiatrist in Colorado to 1.80 in Arizona. Across the 50 states and the District of Columbia, psychiatrists still outnumbered them: 60,364 PMHNPs and 67,991 psychiatrists, or 0.89 per psychiatrist.

The states we serve compared

Every state on this list had more PMHNPs than psychiatrists with a practice address there. Arizona had the most PMHNPs per psychiatrist (1.80) and Colorado the fewest (1.13). Across the 50 states and DC, PMHNPs outnumbered psychiatrists in 29.

Does practice authority line up with the ratio?

The AANP sorts states into three groups by how much independence state law gives nurse practitioners. In full-practice states, nurse practitioners can evaluate, diagnose and prescribe under the board of nursing alone. In reduced-practice states, the law requires a career-long collaborative agreement or limits a part of practice. In restricted-practice states, it requires career-long supervision, delegation or team management by another clinician. Of the states we serve, the AANP classes Texas and Florida as restricted and New Mexico, Alaska, Arizona, Colorado and Washington as full practice.

Across all 50 states and DC, the typical ratio was higher where nurse practitioners have more independence: a median of 1.24 PMHNPs per psychiatrist in full-practice states, 1.09 in reduced-practice states and 0.80 in restricted-practice states. The groups overlap widely, though. Texas and Florida are restricted-practice yet have more PMHNPs than psychiatrists, while several full-practice states have far fewer. States also differ in population, training programs, pay and how many psychiatrists they had to begin with, so these counts cannot show that practice rules cause the difference.

A newer workforce

About half of the PMHNPs on the registry today got their NPI in 2021 or later, compared with about one psychiatrist in ten. The pattern holds in every state we serve.

What this means for people looking for psychiatric care

• Many of the clinicians you find will be nurse practitioners. In each of the states we serve, the federal registry lists more psychiatric nurse practitioners than psychiatrists. When you compare options, ask any clinician about their training, their licence and how they work with other clinicians.
• The rules differ from state to state. In Texas and Florida, state law requires career-long supervision, delegation or team management by another clinician for nurse practitioners, in the AANP’s summary. Texas, for example, does not let nurse practitioners prescribe Schedule II medications, which include the main ADHD stimulants, outside hospital and hospice settings, so stimulant prescriptions for Willow & Stone’s Texas patients are written by the collaborating physician who works with Dr. Forbes.
• You can check anyone’s credentials. The NPI Registry shows a clinician’s registered specialty and practice address, and each state’s board of nursing or medical board has a free licence lookup. A clinician can see you by telehealth only in a state where they hold a licence, wherever their office is.
• A count is not an appointment. The registry shows who is registered, not who is taking new patients, how long the wait is or what a visit costs. Ask about those before you book.

Method

We used the full NPPES downloadable file published by the Centers for Medicare & Medicaid Services on November 9, 2026, with records through November 2, 2026. Every health care provider who bills electronically in the U.S. needs a National Provider Identifier (NPI), and the file lists each one with up to 15 provider taxonomy codes, one of them marked primary, and a primary practice address.

We counted individual providers (not organizations) whose NPI was active and whose primary taxonomy was Nurse Practitioner, Psychiatric/Mental Health (code 363LP0808X) or one of the six psychiatry codes in the NUCC taxonomy: Psychiatry (2084P0800X), Child & Adolescent Psychiatry (2084P0804X), Geriatric Psychiatry (2084P0805X), Addiction Psychiatry (2084P0802X), Forensic Psychiatry (2084F0202X) and Psychosomatic Medicine (2084P0015X). Each provider counts once, in the state of their primary practice address. Rates use the Census Bureau’s Vintage 2025 population estimates for July 1, 2025, and practice categories come from the AANP State Practice Environment map, updated May 2026 and read on November 12, 2026.

To check the counts, a second script looked up every PMHNP and psychiatrist in each of the states we serve through the live NPI Registry, and re-counted the national totals from the file with a separate method. The two agreed within a few registrations, the difference expected between a live registry and a file dated November 2, 2026.

Limits of the data

• A registry, not a workforce survey. The NPI file shows who registered and what specialty they chose. NPIs stay active unless deactivated, so some people who have retired or left practice are still counted, and the specialty is self-reported rather than a verified board certification. Both groups are affected.
• Primary specialty only. Providers who list a psychiatric code only as a second specialty are not counted. Counting a code in any of the 15 slots gives 65,000 PMHNPs and 70,204 psychiatrists nationally (0.93 per psychiatrist), and PMHNPs still outnumber psychiatrists in every state we serve.
• Who counts as a psychiatrist. General psychiatry (2084P0800X) makes up 85% of the psychiatrists counted here. Counting that code alone would put PMHNPs slightly ahead nationally (1.04 per psychiatrist), because child, geriatric and other psychiatry specialists would drop out.
• One address per person. Clinicians are counted where their primary practice address is. A telehealth clinician may hold licences in several states, and some list an employer’s address, so a count is not the number of clinicians able to see patients in a state.
• Heads, not hours. A part-time clinician counts the same as a full-time one, and the file does not show caseloads or whether anyone is taking new patients.
• First NPI date. The 2021-or-later share uses the date an NPI was first issued. Some PMHNPs had an NPI earlier in another nursing role, so this understates how many are new to psychiatric practice rather than overstating it.
• Rules change. The AANP categories summarize state law as of May 2026. Check your state’s board of nursing for the current rules.

Sources

This page reports public workforce data. It does not say that one kind of clinician is better for anyone, and it is not medical advice.