Student guide for licensure

Edited by Kristelle Cefre in July 2024

Edited by Tyler R. Hood in March 2026

For anyone who has passed the National Board Certification in Occupational Therapy ® (NBCOT) exam, congratulations! Now that you’re a registered practitioner, what does licensure look like?

Well, your certification from the NBCOT is not the same as a state licensure. Currently, all 50 states and the District of Columbia, Puerto Rico, and Guam require an occupational therapist (OT) and certified occupational therapy assistant (COTA) to obtain a license in order to provide our services (American Occupational Therapy Association [AOTA], n.d.). The general goal for this article is to provide you with the tools and steps relevant to the licensure process. Additionally, this article will support any setting, whether it be a school, hospital, military, or travel therapy role. Applying for the licensure process is likely to be frustrating if you are not prepared or do not have the resources to support you.

State Licensure Application. Each state can include different steps to become licensed. Some of these can include (AOTA, 2020):

• Documentation supporting graduation from an Accreditation Council for Occupational Therapy Education® (ACOTE) approved institution, where you obtained your OT/COTA degree and official final transcript
  • Documentation of completed fieldwork (typically, this is included in the final transcript)
• Official NBCOT® certificate
• Initial state licensure application and fee
• State and/or federal criminal background check
• Letter of recommendation
• Documentation to support passing the state exam, typically known as the state law or state jurisprudence exam

If you are seeking additional assistance with state-specific requirements, be sure to visit your state’s occupational therapy regulatory authority website. You can also review this information in the OT or OTA qualifications and licensure requirements document, published on AOTA’s website (log-in required).

What if you want a state that is in the OT Compact? If you live in or plan to work in a state that is a part of the OT Compact, complete the following steps:

• Go to the OT Compact website
• Read the “Before You Apply” article to ensure that you are educated on the OT Compact and what enrolling will look like
  • Ensure that you are licensed, reside in, and meet all other eligibility requirements in at least one of the accepted states
• Apply for the OT Compact Privileges
• Register as a Practitioner
• Fill out the “License type,” “State of home license,” “Name,” “Last 4 of SSN,” “Date of birth,” and “Email”
  • Select “Next”
• Confirm that the account summary is correct and proceed

More on the OT Compact. The OT Compact is an interstate compact and formal agreement where OTs and COTAs who are licensed in a Compact member state can practice in other Compact member states (known as a compact privilege) without needing additional state licenses. The OT Compact began accepting applications on January 12, 2026 for three states (Minnesota, Ohio, and West Virginia). To stay up to date on the status of your state (or others) check out the official OT Compact Map. You can learn more about the OT Compact and stay up to date by visiting their website or reading AOTA’s recent article on the Compact’s beginning.

Keeping up-to-date. Keeping up-to-date on your licensure and your state’s regulations is important to increase our profession’s influence on state policies and to discover new networking and continuing education units (CEUs) with fellow practitioners. A list of each of the state associations, their contact information, scholarships, conferences, and more can be found at AOTA’s website.

State Credentials. Verify which credential abbreviations are standard in your state (such as OTRL, OTR/L, COTAL, or COTA/L). NBCOT holds trademarks on the OTR and COTA designations, which are reserved for individuals who maintain active certification. The “L” denotes state licensure. It’s worth noting that not all states require NBCOT renewal after your initial certification, meaning some therapists may sign their credentials as OT/L. This information can be difficult to find, so make sure to contact your state board directly to verify the policies and practices for certification and license renewal. Additionally, some professionals sign their name using only their degree (MOT, MSOT, OTD, PPOTD, etc.) to indicate their background if they have transitioned career paths outside of direct OT practice and no longer hold active certification or state licensure.

AOTA & state memberships. Maintaining your AOTA and state association memberships is key to maintaining access to practice resources, articles, national legislation, and networking on local and national scales. Plus, many state associations hold free CEUs with their membership. With a practitioner needing multiple units to recertify, this is a key way to access them and support your state and national associations.

Occupational Therapy & COTA license application/renewal plans. We are hopeful the OT Compact will disperse throughout the nation and territories as the years continue. However, until that occurs, it is important to stay cognizant of the licensure process and requirements for the states/territories where you are applying to or inhabiting. Follow these steps to stay proactive throughout your professional practice.

• Keep track of when you submitted your application and monitor the processing time
• Develop or purchase a CEU tracker and keep records of your certifications and licenses
  • Check with your state’s licensing board to confirm whether continuing education requirements are adjusted for your initial renewal period. Your first cycle may be shortened based on when you received your license, and some states waive or modify CEU requirements for the initial renewal.

WARNING. Stay alert to fraudulent registration and licensing schemes. Years past have seen reports of scammers posing as licensing board officials or law enforcement officers who demand payment or confidential information from practitioners to use unethically. Remember to keep yourself and your license safe.

References

American Occupational Therapy Association (AOTA). (2020). Occupational therapy initial licensure application checklist. Aota.org. https://www.aota.org/-/media/corporate/files/advocacy/state/ot-initial-licensure-application-checklist.pdf

American Occupational Therapy Association (AOTA). (n.d.). Career Licensure. Aota.org. https://www.aota.org/career/state-licensure