Jasper Victor Otvertchenko, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

130929 Issued in NY

Practice address

7 Pine Woods Road
Suite 7
Hyde Park, NY 12538

Phone

(845) 233-5935

Fax

(845) 233-4726

NPI assigned

May 27, 2026

Last updated

May 27, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1779840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1144151366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 PINE WOODS ROAD",
            "address_2": "SUITE 7",
            "city": "HYDE PARK",
            "state": "NY",
            "postal_code": "12538",
            "telephone_number": "845-233-5935",
            "fax_number": "845-233-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 PINE WOODS ROAD",
            "address_2": "SUITE 7",
            "city": "HYDE PARK",
            "state": "NY",
            "postal_code": "12538",
            "telephone_number": "845-233-5935",
            "fax_number": "845-233-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTVERTCHENKO",
        "first_name": "JASPER",
        "middle_name": "VICTOR",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-27",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "130929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Couse Norman, MS,CCC-SLP
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• Lorene Elizabeth O'Connell, LMT
• Rupal Deepak Parikh, MD
• Kristi Parson, PHARMD
• Dipti Harish Patel, DDS
• Prerana V Patel, PHARMD
• Pathways Community Support Services, Inc

• Social Worker in Hyde Park, NY
• Providers in Hyde Park, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.