21 NCAC 53 .0602 RENEWAL FOR LICENSURE FORM; ADDRESS CHANGE; NAME CHANGE
(a) License renewal information shall be on the Renewal for Licensure forms available on the Board's website www.ncblpc.org, and submitted either electronically or mailed in paper format to the Board's office as set forth in Rule .0204 of this Chapter. The licensee shall provide general contact information, licensure or credentials, and all continuing counselor education information for the past two years. All requested information shall be provided and the forms shall be signed and dated. Documents that shall be included with the renewal form are the following:
(1) certificate of completion of the jurisprudence examination for the level of license that is being renewed;
(2) the ethics attestation statement;
(3) an updated Professional Disclosure Statement; and
(4) payment of renewal fee.
(b) Change of Address. The licensee shall inform the Board of any change in his or her mailing address within 60 days after any change. Updated address information shall be submitted on forms available on the Board's website, www.ncblpc.org.
(c) Change of Name. The licensee shall inform the Board of any change in his or her name within 60 days after any change. A name change form shall be submitted on forms available on the Board's website, www.ncblpc.org and shall include any required legal documentation, as a marriage certificate, divorce decree, or court order.
History Note: Authority G.S. 90-334(g); 90-336(a); 90-339(b);
Eff. July 1, 1995;
Amended Eff. July 1, 2014.