Harm reduction (HR) approaches to substance use show promising efficacy, but limited research exists exploring professional counselors’ perceptions of HR. An online survey gathered data from 395 substance use providers, including 128 professional counselors. In measuring HR acceptance, t-tests compared this sample to prior samples, an analysis of variance compared counselors to other providers, and multiple regression explored the influence of counselor identity factors. Empathic responsiveness and positive social justice attitudes were predictors of HR acceptance. Counselors’ perceptions of HR were similar to other providers. Results indicated that counselor identity influences HR perceptions, with implications for practice and training considered.