Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Jack Lee Otterstrom, LCSW

Individual provider Professional Counselor · NPI 1922163096

Mr. Jack Lee Otterstrom, LCSW is a Professional Counselor in Independence, Oregon. Practices as a sole proprietor and works from 2 locations. Licensed in Oregon.

Licensed in
OR
In the registry since
2006
Specialties on file
3
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

656 Jasmine Cir
Independence, OR 97351-9578
Phone: (541) 231-8023
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 250 W Marquam St, Mount Angel, OR 97362-9520 — (971) 983-5214

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X (OR)
Professional Counselor Taxonomy 101YP2500X · Licence L5316 (OR)
Clinical Social Worker Taxonomy 1041C0700X · Licence L3516 (OR)

Record details

NPI number1922163096
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedDecember 27, 2006
Last updated in NPPESSeptember 6, 2022
Certification dateSeptember 6, 2022