Becoming an Occupational Therapist in North Carolina

North Carolina occupational therapists help adults and children carry out their daily activities and life roles despite illness, disability, or other impairment. The OT scope is broad. Clients may be challenged by developmental impairments, physical or emotional conditions, injuries, or advanced age.

Achieving Occupational Therapy Licensing in North Carolina

North Carolina licensing standards are based on those of a national certifying body. There are additional standards at the state level, though they are relatively minor.

Prospective OTs should enroll in programs that are accredited by the Accreditation Council for Occupational Therapy Education. This will ensure that they meet academic requirements to take the national board examination and are license-eligible in North Carolina and other states. Programs are graduate level. They include mandatory fieldwork experiences. Students can be accepted with undergraduate degrees in any field.

North Carolina has five accredited OT programs. One is designed specifically to help occupational therapy assistants “bridge” by earning the higher degree and higher license.

Candidates will go through the National Board for Certification in Occupational Therapy for OT examination.

The examination is offered at testing sites around the country. North Carolina also requires candidates to pass an online jurisprudence examination; this covers the state practice act and regulations. Candidates will take the exam after initiating the license application process. Any candidate scoring less than 100% on the state test of laws and rules will need to retake it.

NBCOT has procedures in place for determining eligibility for internally educated candidates.

Prospective OTs can expect character or background review at multiple stages along the way. A North Carolina license applicant will need to have two occupational therapy professionals fill out Certification of Character forms.

North Carolina does not require occupational therapists to maintain their national certification but notes that they won’t be able to use the title ‘OTR’ unless national certification is current The state does set continuing competency requirements; these can be met in multiple ways.

Occupational Therapist Roles

OTs assess many factors that contribute to functional ability, environmental as well as client-centered. Treatment can take many forms. OTs may develop or restore functional skills and adapt environments and tasks. They are knowledgeable about assistive and orthotic devices. They may utilize physical agent modalities (e.g. heat) to increase functional ability. They can support people who have difficulty with particular functions like swallowing and those who need help with complex tasks like cleaning their home, getting around the community, and supporting themselves. They can potentially take on many roles, including care coordination. OTs may be involved with disability prevention and wellness. Multiple North Carolina OT schools, notably, have been involved with fall prevention.

Treatment may be provided by occupational therapists and occupational therapy assistants, but there are many steps that the occupational therapist bears responsibility for. OTs direct evaluation and determine whether a person needs services and what the priorities are. The OT has responsibility for the treatment plan though the occupational therapy assistant may contribute. Ultimately, the OT determines whether treatment needs to be continued or whether the client is ready for discharge. OTs supervise occupational therapy assistants as they carry out portions of the treatment and evaluation process and make preparations for discharge.

North Carolina Employers

The following are among the many facilities and organizations where OTs practice:

• New Hanover Regional Medical Center
• Raleigh Therapy Services,
• Inc Jabulani Kids Pediatric Therapy, PC
• Amedisys
• Brian Center Health & Rehabilitation/Spruce Pine

North Carolina Occupational Therapist Salary and Career Outlook

North Carolina occupational therapists earned an average salary of $84,390 in 2018. The 10th percentile salary was $56,690; the 90th percentile salary, $117,130.

The highest reported salary averages ($98,870) were in the New Bern area. Here, too, there was a range, with OTs at the 10th percentile making $75,580 and those at the 10th percentile making $125,530.

In the Winston-Salem metropolitan area, the average also topped 90K.

The North Carolina OT occupation has been projected to see 18.8% growth over the course of the 2016 to 2026 decade.

The New Bern, Asheville, and Wilmington metropolitan areas have greater than average OT job concentration, though one will find greater numbers of OTs employed in the populous Charlotte area.

Occupational Therapy Schools in NC

The University of North Carolina–Chapel Hill is a top program, ranked #9 in the nation by U.S. News and World Report. The school offers a Master of Science. The program is highly competitive. UNC-Chapel Hill reports that in recent years, they have had about 246 applications for 24 slots. The average admitted student has a 3.6 GPA and above average GRE scores; applications are strengthened by occupational therapy experience, diversity experience, and scholarly writing ability. UNC master’s students participate in faculty-led research. They have multiple service opportunities; some are offered through the Student Occupational Therapy Association. The American Occupational Therapy Association reports that UNC is in the process of transitioning to an entry-level doctorate.

East Carolina University offers an entry-level master’s program which provides students with a foundation in research as well as clinical practice. Thesis is optional. The school has published summaries of faculty research interests.

Winston-Salem State University offers an MSOT program through its School of Health Sciences. The Department of Occupational Therapy provides outreach at a Community Care Clinic. The school involves OT students in multiple service projects including life skills at homeless shelters.

Student and Professional Resources

Licensing information is available from the North Carolina Board of Occupational Therapy ( The Board can be reached at 919-832-1380.

The North Carolina Occupational Therapy Association is the state professional association ( NCOTA has eight special interest sections. Among them are physical disability, mental health, gerontology, home health, and pediatrics.