How to get an Occupational Therapy (OT) License in North Carolina.

To become a licensed occupational therapist in North Carolina, you must complete an accredited degree program, pass national and state exams, and apply for licensure through the state board. Once your North Carolina OT license is issued, you can begin practicing legally in clinical, school, or healthcare settings.

At a Glance: North Carolina OT License Requirements

To become a licensed occupational therapist in North Carolina, you must:

• Earn a master’s or doctoral degree in occupational therapy
• Graduate from an ACOTE-accredited program
• Pass the NBCOT certification exam
• Pass the North Carolina jurisprudence exam
• Apply for state licensure through the North Carolina Board of Occupational Therapy

Step 1: Complete your OT education.

The North Carolina Board of Occupational Therapy (NCBOT) requires you to obtain a master’s degree in occupational therapy to qualify for licensure. The program must be accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) to ensure eligibility for the certification exam.

Master’s vs. Doctorate in Occupational Therapy

If you want to increase your earning potential or explore working in academia, you can earn a Doctor of Occupational Therapy (OTD). This path takes three or more years to complete and can ease the transition from working directly with clients to working in higher education. 

👉 Your choice depends on your career goals, timeline, and interest in clinical vs. academic work.

Fieldwork Experience

During grad school, you’ll gain real-world experience in mandatory fieldwork (practicum) placements.

• Observation of licensed occupational therapists
• Hands-on clinical practice
• Client assessment and intervention planning
• Documentation and progress tracking

Step 2: Pass the required exams

After completing your college coursework, you can apply for and take the NBCOT exam. Passing this exam demonstrates that you’ve met the highest national standards for:

• Clinical competence
• Ethical conduct practice
• Public safety
• Professional readiness - and recertification requirements for continued competence.

Jurisprudence exam

You’ll also have to complete the North Carolina Board of OT’s jurisprudence exam. This free exam is administered online and covers the legal principles and theory of the North Carolina OT Practice Act and the Board's rules.

Step 3: Apply for North Carolina OT licensure

Once you pass the exam, you’ll be eligible for state licensure. You may submit your state licensure application when you apply for the NBCOT exam, which can help streamline the process.

Application Process Includes:

• NBCOT certification verification
• Background and moral character review
• State verification forms
• Online application submission

💡 The application fee is approximately $10, and many applicants submit their licensure application while registering for the NBCOT exam to streamline processing

After completing all the required fields, you can submit your application to the Board for review.

Is now a good time to become an OT in North Carolina?

Yes, now is a great time to get your North Carolina OT license. This role is in high demand nationwide, including in North Carolina. According to the U.S. Bureau of Labor Statistics, OT positions are projected to grow by 14% nationally through 2034.

These positions also offer long-term employment opportunities in diverse settings, including hospitals, schools, and clinics.

What does a school-based OT do?

School-based OTs help students build essential life skills to participate in their learning environment as independently as possible. Their work helps students access academic, social, and physical tools to navigate school successfully and improve their well-being. 

Support diverse learners

• Assist students in general and special education
• Provide individual and group interventions
• Support early intervention services

Fine motor skill development

• Improve handwriting
• Support scissor use and classroom tools
• Strengthen coordination skills

Life skills training

• Organization and classroom routines
• Dressing and self-care skills
• Managing school materials

Sensory and emotional regulation

• Help students focus and self-regulate
• Use movement breaks and sensory strategies
• Support classroom participation

Classroom adaptation

• Modify seating or learning environments
• Reduce sensory barriers
• Improve accessibility for students

Collaboration

• Work with teachers, parents, and specialists
• Help design and implement IEP goals
• Support student success across environments

Grow your career with Kelly Pediatric Therapy.

At Kelly Pediatric Therapy we work with occupational therapists, speech-language pathologists, physical therapists, psychologists, mental health professionals, and other providers find the right school-based placements.

If you're looking to move forward in your professional career in a way that supports growth, balance, and impact—consider working with us as a school-based therapist.

When you work with Kelly Pediatric Therapy, you’ll enjoy competitive pay, compensation for documentation, access to mentorship, free professional development, and work-free nights, weekends, and holidays. 

Learn more about joining our team.