Licensure guide · North Carolina

How to get a North Carolina occupational therapy license

Occupational therapists in North Carolina are licensed by the North Carolina Board of Occupational Therapy. Below is what the board requires, from education to renewal, with every requirement linked to the board page it comes from. Checked October 22, 2026.

Step by step

Getting licensed

Education: Occupational therapist applicants must have completed an accredited occupational therapy educational curriculum and the required supervised fieldwork. [2]
National exam: Applicants must have passed the National Board for Certification in Occupational Therapy (NBCOT) exam. [3]
State law exam: Applicants must pass the Board's online jurisprudence exam on the North Carolina OT Practice Act and Board rules, scoring 100% on 30 multiple-choice questions; there is no fee and it may be retaken. [4]
Fees: Applicants pay $10 to purchase the online application and a non-refundable $100 licensure fee. [3]
Where to apply: Applicants purchase an online application from the Board's Application Process page, then complete and submit it online. [3] Open the application →
Processing time: Licenses are usually issued within 1 to 2 weeks after the application and all required documentation are received and processed by the Board office. [7]

Moving to the state

Already licensed somewhere else?

North Carolina has enacted the OT Compact but is not yet issuing compact privileges, so occupational therapists and occupational therapy assistants licensed elsewhere still need a North Carolina license for now.

Licensed in another state: The Board may exempt applicants from certain licensure requirements if they prove current OT licensure in another state, the District of Columbia, Puerto Rico or Guam whose standards the Board considers substantially equivalent or higher. [2]
Interstate compact: North Carolina enacted the Occupational Therapy Licensure Compact when the Governor signed House Bill 224 on June 11, 2021. [6]

Before your full license

New graduates and clinical fellows

Temporary or provisional license: The Board does not offer a temporary license; applicants must complete the licensure process and be issued a regular license before they may practice. [3]

After you are licensed

Keeping the license active

Renewal: Licenses are renewed every year online between April 1 and June 30; the renewal fee is $50, with an additional $50 late renewal fee. [5]
Continuing education: Licensees must document at least 15 continuing competence activity points for each annual renewal, including at least one point in ethics; licensees renewing for the first time are not required to provide points. [5]

Working in North Carolina

Pay and openings

Occupational therapists in North Carolina earn a mean of $91,360 a year (BLS). Most of our North Carolina searches are confidential and never posted; tell us what you want and we will match you quietly.

Sources

Every requirement above was checked against the official page listed here on October 22, 2026. Boards change fees and rules, so confirm with the North Carolina board before you apply. This page is a guide, not legal advice.

Other North Carolina licenses

Occupational therapy licenses in other states

State-by-state license guides →

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