4.2.6.4Vertical

Solo Practice Therapists & Counselors

Individual licensed therapists and counselors in private practice.

Market snapshot

These figures describe Outpatient Mental Health Services (4.2.6), the segment that Solo Practice Therapists & Counselors sits within. They are not figures for Solo Practice Therapists & Counselors on its own.

Market size
~$64B
Growth
~11.9%CAGR (2017–22, nominal)
Companies
~60,807 firms
Firms by employee count

91.2% of firms have fewer than 20 employees: 55,428 micro-businesses, below most mandates.

The investable universe5,379 firms with 20+ employees
20–99
3,47665%
100–499
1,22523%
500+
67813%

The largest and fastest-growing behavioral segment: psychiatrists' offices, therapist and counselor practices, and outpatient mental-health and substance-abuse centers. Growth ran near 12%/yr as demand surged, telehealth expanded access, and parity rules improved reimbursement; the ~61,000 firms are overwhelmingly small practices, which is what makes it the marquee behavioral roll-up (LifeStance, Refresh, and peers).

NAICS 621112, 621330, 621420. U.S. Census Bureau, 2022 Statistics of U.S. Businesses; U.S. Census Bureau, 2022 Economic Census.

Business model & economics

Revenue model

Fee-for-service therapy and psychiatry reimbursement

Key economics

Revenue per firm
$1,055,205
Revenue per employee
$102,374
Employees per firm
9.7
Recurring revenue
High

recurring therapy and medication management

EBITDA margin
10–20%
Capex intensity
Low

Characteristics

  • Balanced cost base: payroll is 46% of revenue, leaving room to scale margin without cutting staff
  • Deep strategic-buyer pool: 678 firms exceed 500 employees, so a scaled asset has trade buyers
  • Largest and fastest-growing behavioral-health segment.
  • PE roll-up tempered by clinician recruitment/retention.
  • Recurring therapy relationships and broad demand.

NAICS 621112, 621330, 621420. U.S. Census Bureau, 2022 Statistics of U.S. Businesses; U.S. Census Bureau, 2022 Economic Census.

Geographic concentration

AlabamaAlaskaArizonaFloridaGeorgiaIndianaKansasMaineMassachusettsMinnesotaNew JerseyNorth CarolinaNorth DakotaOklahomaPennsylvaniaSouth DakotaTexasWyomingConnecticutMissouriWest VirginiaIllinoisNew MexicoArkansasCaliforniaDelawareDistrict of ColumbiaHawaiiIowaKentuckyMichiganMississippiMontanaNew HampshireNew YorkOhioOregonTennesseeVirginiaWashingtonWisconsinSouth CarolinaIdahoNevadaVermontLouisianaRhode IslandColoradoMarylandUtahNebraska

Outpatient mental-health practices cluster in Nebraska, Colorado, Utah, and Maryland rather than tracking population. Those states are a mix of high-access, well-reimbursed markets where therapist and psychiatry practice density runs highest.

NebraskaColoradoUtahMaryland

U.S. Census Bureau, 2022 Statistics of U.S. Businesses (firms by state), NAICS 621112/621330/621420. Concentration shown by location quotient.

M&A deal context

Deal activityHigh

Who’s acquiring

  • PE-backed outpatient platforms
  • Behavioral-health consolidators
  • Payer-aligned providers

What’s driving deals

  • Roll-up of fragmented therapy and psychiatry practices.
  • Surging demand and expanded coverage.
  • Clinician-supply constraints shaping economics.

Find Solo Practice Therapists & Counselors acquisition targets

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