Certification vs licensure
A national certification and a state license are different things. NBCOT says “Certification is not the same as licensure.” ASHA says “ASHA certification is voluntary.” For physical therapy, the NPTE is a step toward a license that the state issues. In every case, the right to practice comes from the state.
Quoted from official pages checked November 10, 2026. Confirm current requirements, fees, and dates on those sites. This page is not legal advice and does not guarantee eligibility, certification, or licensure.
Occupational therapy (OTR and COTA)
NBCOT’s Get Certified page, checked November 10, 2026, states: “Certification is not the same as licensure.” NBCOT’s What is an OTR or COTA professional? page states: “OTR and COTA professionals are also state-licensed professionals.” Its After your exam page states: “Passing your exam is different from applying for state licensure. You will need to apply for a state license in order to practice.”
BLS’s occupational therapists page states: “All states require occupational therapists to be licensed.” It also states: “Therapists must pass the qualifying exam to use the title ‘Occupational Therapist Registered’ (OTR).” Its assistants and aides page states: “Occupational therapy assistants usually need a state-issued license.”
Physical therapy (PT and PTA)
FSBPT’s NPTE page states: “Taking the National Physical Therapy Examination (NPTE) is an important step toward receiving your physical therapist (PT) or physical therapist assistant (PTA) license.” BLS’s physical therapists page states: “All states require physical therapists to be licensed, which includes passing a qualifying exam.” Its assistants and aides page states: “All states require physical therapist assistants to be licensed or certified.”
Board-certified specialist credentials are separate again. BLS states: “After gaining work experience, some physical therapists choose to become a board-certified specialist.” See specialties.
Speech-language pathology (CCC-SLP and C-SLPA)
ASHA’s Benefits of ASHA Certification page states: “ASHA certification is voluntary.” ASHA’s general information page states that those who have achieved the CCC “have voluntarily met rigorous academic and professional standards, typically going beyond the minimum requirements for state licensure.”
BLS’s speech-language pathologists page states: “All states require speech-language pathologists to be licensed.” It also states: “Certification typically satisfies some or all of the requirements for state licensure and may be required by some employers.” The ASLP-IC FAQ states that holding the CCC “is not a requirement to participate in the compact. However, each member state retains authority over the requirements for licensure in their state.”
For assistants, ASHA states: “Support personnel licensure varies from state to state.” See how to become an SLPA.
What this page does not do
It does not tell you whether to get certified, licensed, or both, and it is not legal advice. Your state board and employer set what they require. Start with verify a credential or find a board and after the exam.