How to Become a Speech Therapist in North Carolina

Speech-language pathology is an evidence-based field focused solely on diagnosing and treating communication and swallowing disorders. Through the practice of SLP, speech-language pathologists work to improve the quality of life for children and adults with difficulties related to articulation, apraxia of speech, dysarthria, expressive and receptive language disorders, voice disorders, fluency disorders, cognitive-communication disorders, and feeding and swallowing.

There are plenty of new developments in speech-language therapy across North Carolina, thereby creating exciting opportunities for SLPs to make a difference in the lives of those with speech and language disorders and difficulties.

For example, WellCare of North Carolina, a Medicaid health plan, and Expressable, which provides family-centered speech therapy care, announced in 2024 that were expanding their partnership to offer advanced speech therapy interventions to underserved populations in North Carolina. Throughout the prior year, WellCare and Expressable came together to offer a pilot program that provided children with home-based screenings and speech therapy. Thanks to the success of this program, they’re expanding to include SLP services for all WellCare members throughout North Carolina. The expanded program will identify children ages 0-19 using their advanced screening tools and provide them with personalized care through at-home services.

If you want to become part of North Carolina’s expanding SLP profession, you’ll need to earn state licensure through the North Carolina Board of Examiners for Speech-Language Pathologists and Audiologists.

Follow the steps in the guide below to learn how to become a speech-language therapist in North Carolina:

	Earn a Master’s Degree in Speech-Language Pathology from an ASHA-Accredited Program in New Jersey
	Pass the National SLP Exam
	Apply for a Temporary License and Complete a Supervised Experience Year (SEY)
	Apply for Licensing and Begin Practicing as a Speech-Language Pathologist
	Renew Your License Every Three Years

Step 1. Earn a Master’s Degree in Speech-Language Pathology from an ASHA-Accredited Program in New Jersey

The first step to becoming an SLP involves earning a master’s degree that’s accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA), part of the American Speech-Language-Hearing Association (ASHA).

You may choose from online accredited options, or you may earn your degree from one of six CAA-accredited institutions in the state.

While some SLPs choose online options because of the flexibility of the programs and the ability to complete clinical hours close to home, in-state options often offer reduced tuition or state-sponsored scholarship opportunities.

You’ll need to be prepared to present an excellent academic record when applying to an SLP program in the state. SLP graduate programs usually only admit students who have an excellent academic history, including an undergraduate GPA of at least 3.0, GRE scores in the 30^th percentile, and several academic references.

You won’t need an undergraduate degree in speech-language pathology to be accepted into a graduate program, but you will need to complete prerequisites if you haven’t already completed basic speech therapy fundamentals in your undergraduate courses.

Prerequisites include courses in the biological and physical sciences, as well as social and behavioral sciences:

• Phonetics
• Anatomy of Speech and Hearing
• Neurology of Speech
• Language Development Across the Lifespan
• Acquisition of Development of Articulation
• Aural Rehabilitation
• Speech Science

Core courses move into more advanced topics in speech-language pathology, such as:

• Language Disorders
• Voice Disorders
• Articulation Disorders
• Multicultural Communication Disorders
• Methods in SLP
• Language and Learning Disabilities
• Dysphagia
• Brain, Language & Aphasia
• Linguistic/Cognitive Disorders

Electives often narrow in on special patient populations or communication disorders. They may include:

• Craniofacial Anomalies
• Alaryngeal Rehabilitation
• Professional Issues in SLP
• Stuttering
• Motor Speech Disorders
• Research in SLP

You’ll also need to complete a practicum of at least 400 clock hours during your graduate study to be eligible for licensure in North Carolina. These hours must include at least 25 hours of guided observation and 375 hours of direct patient contact. You’ll complete these hours under the supervision of a licensed SLP.

Step 2. Pass the National SLP Exam

Next, you’ll need to register for the National Examination in Speech-Language Pathology (Praxis exam 5331), the American Speech-Language-Hearing Association’s (ASHA) examination for licensure. You must take and pass this exam by the end of your SEY (see Step 3).

You’ll register online for the exam through Praxis.

When you register for the Praxis, you’ll choose a date, time, and location for your exam. You can take this exam at any Praxis testing center throughout the U.S. In North Carolina, there are testing centers located in:

• Asheville
• Boone
• Cary
• Charlotte
• Cullowhee
• Durham
• Fayetteville
• Greensboro
• Greenville
• Raleigh
• Wilmington

The exam is made up of 132 questions and is scored on a 100-200 scale. You’ll need a 162 to pass.

The exam covers topics that you studied in your core coursework, touching on foundations and professional practice, how to screen, assess, evaluate and diagnose patients, and how to properly develop treatment plans for patients.

The test also covers:

• Feeding and swallowing disorders
• Developing case histories
• Selecting appropriate assessment procedures
• Assessment of anatomy and physiology
• Speech sound production
• Voice, resonance, and motor speech
• Cognitive aspects of communication
• The etiology of communicative disorders

If you feel that you need some extra preparation for the exam, you may browse the test’s topics and practice questions in the Praxis Study Companion.

After taking the exam, it usually takes about two weeks to hear back from Praxis with your scores.

Step 3. Apply for a Temporary License and Complete a Supervised Experience Year (SEY)

Once you’ve graduated from your SLP master’s program, you’ll apply for temporary licensure through the online portal of the Board of the Examiners, so you can begin your supervised clinical experience year (SEY), most commonly referred to as a clinical fellowship.

Along with your application and application/licensure fee of $70, you’ll need to:

• Take an open-book quiz on the laws and rules in the state of North Carolina (located at the end of the application)
• Submit your official transcripts (sent directly from your school to [email protected])
• Submit your passing Praxis score (if completed)
• Submit a completed and signed Clinical/Program Director page (sent directly to [email protected])
• Submit a completed and signed SEY Plan (sent directly to [email protected])

During your supervised experience year, you’ll be supervised by a licensed SLP in North Carolina in a clinical setting as you learn to complete the clinical and diagnostic procedures required of an SLP in day-to-day practice.

The director of your university’s communicative sciences and disorders program may be able to help you find a clinic where you can gain your supervised experience, or you can browse opportunities here.

You may complete your SEY through full-time work, which is defined as nine months of 30 hours per week, or part time work, defined as 18 months of at least 20 hours per week.

Your SEY plan, which you will develop with your supervisor, will break down the number of hours you’ll be expected to spend in assessment, diagnosis and evaluations; screening; habilitation, rehabilitation, and therapy; and counseling, staff meetings, and record keeping.

CCC-SLP Certification

After passing the Praxis exam and completing your clinical fellowship, you’ll be eligible to apply for the Certificate of Clinical Competence in Speech-Language Pathologists (CCC-SLP). It’s not a requirement for licensure, but it adds credibility to your resume, especially if you plan on practicing independently. You’ll apply directly to ASHA for this certification.

Step 4. Apply for Licensing and Begin Practicing as a Speech-Language Pathologist

Once you’ve completed your SEY and passed the Praxis exam, you’ll transition from a temporary to permanent license by submitting your SEY Report (may also be completed through the online portal) and paying the $60 licensure fee.

Once you’re licensed, you’ll have several options available for launching your career:

Work for your Supervised Experience Year Provider

Your supervised experience year provider may be happy to provide you with a full-time opportunity after having first-hand experience with your clinical practice. This is often an excellent way to jump-start your career since you may have already built strong relationships with patients and patients’ families at this clinic.

Consider Starting an Independent Practice

If you want to work independently, you may open your own practice. You also have the option of starting a partnership with another qualified SLP.

Pursue Job Openings in North Carolina

You’ll also be able to pursue a variety of job opportunities in North Carolina, as the state is full of openings for qualified individuals. Just a few SLP employers in the state include:

• Speech Center, Inc.
• Therapy Playground
• Venture Rehab Group
• The People Link Corporation
• Carolina Pediatric Dysphagia Group
• Kinetic Physical Therapy and Wellness
• Wake County Public Schools
• Carolinas Public Health Care System
• Therapeutic Outreach
• Transitions Life Care
• Liberty Healthcare and Rehabilitation Services
• Centra Healthcare Solutions
• Little Bug Speech Therapy
• Cobb Pediatric Therapy Services

Step 5. Renew Your License Every Three Years

You’ll need to renew your license annually for a $60 fee. You’ll complete the renewal process through the Board of Examiners’ online portal. You must complete at least 30 hours of continuing education during every three-year licensure period.

Proof of continuing education is not required; instead, you’ll sign a statement confirming that you’re in compliance with CE standards. You may be subjected to a random audit of your continuing education documentation.

When seeking continuing education opportunities, consider taking advantage of conferences and courses held by the American Speech-Language-Hearing Association or the North Carolina Speech, Hearing, and Language Association.

Many new SLPs join the North Carolina Speech Hearing & Language Association (NCSHLA) to boost their professional development. Through the NCSHLA, you might learn about how to incorporate toys and play as a way to enhance sessions with children, how to treat motor speech disorders, establishing vocal-verbal skills for children with childhood apraxia, and how to enhance feeding therapy through a sensory-motor approach.

Speech-Language Pathology Salary in North Carolina

The average salary for speech-language pathologists in North Carolina is $84,650, or $40.70 an hour.

SLPs in North Carolina at the top of the pay scale (90^th percentile) earn about $114,790, or $55.19 hourly.

Between 2019 and 2023, the average salary for North Carolina SLPs increased by 13%. Those at the entry level (10^th percentile) saw a salary increase of 25%, while the most experienced (90^th percentile) saw average salaries increase by about 2%.

High salaries are one demonstration of the value North Carolina places on its SLPs. Community is another: you won’t find any other city in the nation with a higher concentration of SLPs than you will in Greenville.

In general, North Carolina is home to the ninth-largest number of SLPs in the nation: 4,810 professionals strong.

Salaries for Speech-Language Pathologists in North Carolina’s Major Cities

Charlotte, Greenville, metro Hickory, and Raleigh are home to the highest average salaries for SLPs in North Carolina. The top salaries (90^th percentile) for North Carolina SLPs are found in New Bern, Jacksonville, and Raleigh.

The following cities are sorted by highest average SLP salary. The range between entry-level (10^th percentile) and high-end (90^th percentile) is also provided:

Charlotte:

• Average: $90,250 annually, $43.39 hourly
• $62,470 – $119,410 annually, $30.04 – $57.41 hourly

Greenville:

• Average: $87,480 annually, $42.06 hourly
• $72,170 – $103,740 annually, $34.70 – $49.88 hourly

Metro Hickory:

• Average: $86,160 annually, $41.42 hourly
• $59,240 – $114,790 annually, $28.48 – $55.19 hourly

Raleigh:

• Average: $85,320 annually, $41.02 hourly
• $57,580 – $126,890 annually, $27.68 – $61.01 hourly

Burlington:

• Average: $84,550 annually, $40.65 hourly
• $53,000 – $124,820 annually, $25.48 – $60.01 hourly

Myrtle Beach:

• Average: $83,410 annually, $40.10 hourly
• $60,510 – $117,610 annually, $29.09 – $56.54 hourly

Fayetteville:

• Average: $83,210 annually, $40.00 hourly
• $50,720 – $117,510 annually, $24.39 – $56.49 hourly

New Bern:

• Average: $82,090 annually, $39.47 hourly
• $51,550 – $137,420 annually, $24.79 – $66.07 hourly

Greensboro:

• Average: $82,070 annually, $39.46 hourly
• $47,810 – $108,590 annually, $22.99 – $52.21 hourly

Durham-Chapel Hill:

• Average: $81,960 annually, $39.40 hourly
• $59,070 – $113,840 annually, $28.40 – $54.73 hourly

Wilmington:

• Average: $80,790 annually, $38.84 hourly
• $44,050 – $121,390 annually, $21.18 – $58.36

Winston-Salem:

• Average: $80,570 annually, $38.74 hourly
• $51,430 – $109,100 annually, $24.73 – $52.45 hourly

Asheville:

• Average: $80,550 annually, $38.73 hourly
• $57,140 – $108,110 annually, $27.47 – $51.98 hourly

Rocky Mount:

• Average: $80,409 annually, $38.70 hourly
• $56,830 – $112,320 annually, $27.32 – $54.00 hourly

A Promising Field With High Rates of Job Satisfaction

SLP jobs in North Carolina are projected to increase by 31% in the decade leading up to 2030, which far surpasses the national projected increase of 19% during this time. During this ten-year period, the state should see about 510 annual job openings for SLPs due to a blend of new job growth, retirements, and natural job turnover.

Between 2019 and 2023, the North Carolina cities with the highest increases in SLP jobs included:

• Charlotte –1,150 SLPs, up 5.5%
• Raleigh –730 SLPs, up 28.1%
• Metro Virginia Beach –560 SLPs, static growth
• Durham-Chapel Hill –400 SLPs, up 5.3%
• Winston-Salem – 400 SLPs, up 8.1%

2023 US Bureau of Labor Statistics salary figures shown here for Speech-Language Pathologists. Job growth projections are from the US Department of Labor-sponsored resource, CareerOneStop. Figures are based on state data, not school-specific information. Conditions in your area may vary. Data accessed March 2025.

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