IndividualActive
Jack Otterstrom, LCSW
NPI 1922163096 · Clinical Social Worker · Independence, OR
Provider details
- NPI number
- 1922163096
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- Yes
- License
- L5316 (OR)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(94/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
656 Jasmine Cir
Independence, OR 97351-9578
Phone: (541) 231-8023
Street-level locationGet directions
Mailing address
619 Broad St S # 19
Monmouth, OR 97361-2372
Additional practice locations (1)
- 250 W Marquam StMount Angel, OR 97362-9520Phone: (971) 983-5214Fax: (971) 983-5219
Registry dates
- Enumerated
- 2006-12-27
- Last updated
- 2022-09-06
- Certified
- 2022-09-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.