Healthcare · Rankings

Best US Cities for Therapist (Counselor)s

Top US cities for Therapist (Counselor)s ranked by estimated median salary, with cost-of-living-adjusted earning power.

Top 10 cities by salary
#CityEstimated salaryCost mult.vs national
1San Francisco, CA$66,1001.45×+$16,100
2Honolulu, HI$64,7001.30×+$14,700
3Oakland, CA$63,2001.35×+$13,200
4Boston, MA$62,3001.22×+$12,300
5Irvine, CA$61,8001.30×+$11,800
6Scottsdale, AZ$61,1001.18×+$11,100
7Miami, FL$59,2001.12×+$9,200
8San Diego, CA$59,1001.21×+$9,100
9New York City, NY$58,8001.32×+$8,800
10Yonkers, NY$58,8001.20×+$8,800
All 50 cities, ranked
#CitySalaryHourly
1San Francisco, CA$66,100$32/hr
2Honolulu, HI$64,700$31/hr
3Oakland, CA$63,200$30/hr
4Boston, MA$62,300$30/hr
5Irvine, CA$61,800$30/hr
6Scottsdale, AZ$61,100$29/hr
7Miami, FL$59,200$28/hr
8San Diego, CA$59,100$28/hr
9New York City, NY$58,800$28/hr
10Yonkers, NY$58,800$28/hr
11Anchorage, AK$58,800$28/hr
12Seattle, WA$58,300$28/hr
13Long Beach, CA$58,300$28/hr
14Anaheim, CA$58,300$28/hr
15Chula Vista, CA$57,300$28/hr
16Baltimore, MD$57,100$27/hr
17Philadelphia, PA$56,200$27/hr
18Henderson, NV$56,200$27/hr
19Los Angeles, CA$56,100$27/hr
20Portland, OR$56,000$27/hr
21Newark, NJ$56,000$27/hr
22Sacramento, CA$56,000$27/hr
23Riverside, CA$56,000$27/hr
24Orlando, FL$55,800$27/hr
25Raleigh, NC$55,500$27/hr
26Worcester, MA$55,500$27/hr
27Denver, CO$55,300$27/hr
28Stockton, CA$54,500$26/hr
29Aurora, CO$54,500$26/hr
30Hialeah, FL$54,500$26/hr
31Houston, TX$54,300$26/hr
32Las Vegas, NV$54,200$26/hr
33Minneapolis, MN$54,200$26/hr
34Plano, TX$54,200$26/hr
35New Orleans, LA$53,700$26/hr
36Phoenix, AZ$53,600$26/hr
37Tampa, FL$53,600$26/hr
38Gilbert, AZ$53,600$26/hr
39Salt Lake City, UT$53,600$26/hr
40Wilmington, DE$53,000$25/hr
41St. Paul, MN$53,000$25/hr
42Boise, ID$53,000$25/hr
43Fresno, CA$53,000$25/hr
44Nashville, TN$52,700$25/hr
45St. Louis, MO$52,700$25/hr
46Colorado Springs, CO$52,700$25/hr
47St. Petersburg, FL$52,700$25/hr
48Madison, WI$52,700$25/hr
49Winston-Salem, NC$52,700$25/hr
50Jacksonville, FL$52,200$25/hr
51Memphis, TN$52,200$25/hr
52Mesa, AZ$52,200$25/hr
53Tucson, AZ$51,800$25/hr
54Birmingham, AL$51,800$25/hr
55Glendale, AZ$51,800$25/hr
56Spokane, WA$51,800$25/hr
57Pittsburgh, PA$51,500$25/hr
58Tallahassee, FL$51,500$25/hr
59Chicago, IL$51,400$25/hr
60Austin, TX$51,400$25/hr
61Frisco, TX$51,400$25/hr
62Milwaukee, WI$51,300$25/hr
63Albuquerque, NM$51,300$25/hr
64Chandler, AZ$51,100$25/hr
65San Antonio, TX$51,000$25/hr
66Grand Rapids, MI$51,000$25/hr
67Detroit, MI$50,700$24/hr
68Cincinnati, OH$50,700$24/hr
69Lexington, KY$50,700$24/hr
70Buffalo, NY$50,700$24/hr
71Greensboro, NC$50,700$24/hr
72Knoxville, TN$50,700$24/hr
73Atlanta, GA$50,600$24/hr
74Reno, NV$50,600$24/hr
75Charleston, SC$50,600$24/hr
76El Paso, TX$50,400$24/hr
77Cleveland, OH$50,400$24/hr
78Indianapolis, IN$50,100$24/hr
79Louisville, KY$50,100$24/hr
80Virginia Beach, VA$50,000$24/hr
81Chesapeake, VA$50,000$24/hr
82North Las Vegas, NV$50,000$24/hr
83Dallas, TX$49,700$24/hr
84Bakersfield, CA$49,700$24/hr
85Toledo, OH$49,500$24/hr
86Lubbock, TX$49,500$24/hr
87Norfolk, VA$49,500$24/hr
88Charlotte, NC$49,200$24/hr
89Wichita, KS$49,000$24/hr
90Fort Wayne, IN$49,000$24/hr
91Mobile, AL$49,000$24/hr
92Fort Worth, TX$48,900$24/hr
93Garland, TX$48,900$24/hr
94Arlington, TX$48,600$23/hr
95Columbus, OH$47,800$23/hr
96Kansas City, MO$47,800$23/hr
97Corpus Christi, TX$47,800$23/hr
98Omaha, NE$47,300$23/hr
99Oklahoma City, OK$47,000$23/hr
100Lincoln, NE$47,000$23/hr

Does location actually decide Therapist (Counselor) pay?

Therapist (Counselor) work is usually hybrid, so the metro you choose still largely determines what you earn. Pay ranges from $47,000 in Lincoln to $66,100 in San Francisco — a spread of 41%.

Licensing adds friction the ranking does not show. Therapist (Counselor) requires State license (LMFT) required; needs supervised postdegree clinical hours plus exam, and licenses are issued state by state. Moving for a higher salary can mean re-credentialing, which takes time and sometimes additional exams — check reciprocity with the destination board before treating a pay gap as attainable.

Highest-paying is not the same as best-off

The nominal ranking and the useful ranking are not the same. In San Francisco, $66,100 against $3,000/month rent leaves roughly $30,100 a year after housing. In Lincoln, $47,000 against $950 leaves about $35,600. The bottom of the pay list beats the top once rent is subtracted — which is the whole reason to look past headline salary.

Why these metros and not others

What puts a metro near the top here is employer density, not price level. San Francisco (Salesforce, Google); Honolulu (U.S. Pacific Fleet/Joint Base Pearl Harbor-Hickam, Queen's Health Systems); Oakland (Kaiser Permanente (HQ), Port of Oakland). Where healthcare employers compete for the same candidates, offers rise above what the local cost of living alone would predict.

Salaries are modelled from BLS national medians adjusted for local price level at a wage elasticity below 1 — pay rises with local costs but not proportionally. See our methodology.

Frequently Asked Questions

Which city pays Therapist (Counselor)s the most?
San Francisco, at roughly $66,100. Rent there averages $3,000 a month for a one-bedroom, so about $36,000 of that salary goes to housing before anything else. The metros near the top combine high local costs with concentrated healthcare employment — the second part is what actually lifts pay above the local baseline.
Does a bigger salary here mean more money left over?
Usually not. The cost-adjusted column matters more than the nominal one — a Therapist (Counselor) earning less in a cheaper metro often keeps more. Rank by what remains after housing and tax, not by gross.
Can a Therapist (Counselor) earn big-city pay while living somewhere cheaper?
Sometimes — this role is usually hybrid, so it is possible in principle. It turns entirely on employer policy: some pay by role regardless of location, most use two to four geographic tiers, and some match the company's headquarters city. Ask which applies before assuming the arbitrage is available.
Do I need a new license to work as a Therapist (Counselor) in another state?
Often yes. Therapist (Counselor) requires State license (LMFT) required; needs supervised postdegree clinical hours plus exam, issued state by state. Some states have reciprocity agreements that make the transfer routine; others require re-examination. Confirm with the destination board before treating a higher-paying metro as reachable.